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Crist Proposes Plan To Make Health Insurance Cheaper For Poor

POSTED: Wednesday, February 20, 2008

Many uninsured Floridians would be guaranteed a chance to buy health insurance at what Gov. Charlie Crist hopes could be as low as $150 a month under a plan the governor put forth Tuesday.

The idea was met with interest from businesses, but skepticism from insurers, some of whom say it would be a great idea, but may not be financially realistic.

Crist's proposal wouldn't require that employers offer health insurance, or that people have the coverage, unlike a universal health care plan that Massachusetts created or a plan being pushed by Democratic presidential candidate Hillary Clinton.

Instead, it would allow insurance companies and health plans to offer no-frills policies aimed at providing basic and preventive care. Such policies would be cheaper because they wouldn't be burdened with the requirements of more comprehensive health insurance policies. For example, the policies might not offer coverage for maternity care - which wouldn't be needed by a family that doesn't plan to have children.

The policies would have to cover emergency care and inpatient hospital care, however, under Crist's proposed legislation.

And significantly, the plans would have to guarantee coverage to anyone aged 19 to 64 who can pay for it. Right now, there are some types of insurance that have guaranteed eligibility, but many people can't get insurance.

About 1 in 4 Florida residents don't have health insurance - some because they can't get it and many because they can't afford it. The problem is most acute among people who work for smaller companies, many of which can't afford to pay for health coverage for their workers.

Randy Kammer, vice president of public policy for Blue Cross Blue Shield of Florida and a member of the Florida Health Insurance Advisory Board, said the Crist proposal had "a laudable goal" of trying to increase the number of people with insurance. And the health insurance giant wouldn't oppose the proposal, because it's voluntary - no insurance company would be required to participate.

But Kammer said it doesn't seem likely that companies who aren't allowed to turn anyone away could offer insurance at the bare-bones cost sought by Crist. The existing types of insurance that guarantee eligibility lose money, she noted.

Crist's idea of being able to offer policies as cheap as $150 a month seems a "fairly unrealistic number," Kammer said.

Small businesses, though, praised the Crist proposal.

"Premiums are increasing and options are decreasing; Floridians need a better plan," said Bill Herrle, executive director of the Florida chapter of the National Federation of Independent Business, which is supporting the governor's proposal.

Legislators - who would have to approve of Crist's proposal - are also seeking a solution to what many say is a health care crisis. The House Health Care Council on Tuesday discussed possible options, including a similar no-frills policy idea, although legislation is yet to be drafted by the panel.

The council's chairman, Rep. Aaron Bean, R-Fernandina Beach, said lawmakers want to work with the governor, although Bean admitted he wasn't sure if a measure that guarantees enrollment is possible.

"It's got to be a fair process," for insurance companies, Bean said. "They've got to be able to make some money."

The bottom line for many in the House is that people should be able to buy insurance policies that don't cover things they may not need.

"I want to get us out of the mandate business," said Bean. "I'm talking about a farmer's market of health insurance options."

Rep. Alan Hays says that's the way most companies sell products - noting that car makers can provide power windows, or for less money they can "just do the cranky, cranky windows."

"Why should we require 28-year-old people to have the same kind of insurance coverage that 58-year-old people have," asked Hays, R-Umatilla.

Crist also is proposing to broaden the state's popular KidCare subsidized health insurance program for children. Currently about a quarter of children are ineligible because their family makes too much money. Under the proposal, all children would be eligible, but families who have higher incomes would pay full price rather than the subsidized amount.

Among other ideas, the Crist plan also seeks to lure more dentists to Florida by making it easier for those moving from other states to be licensed here. The proposal also would boost the amount the government Medicaid program pays dentists for treating the poor. Many areas in Florida don't have any dentists that treat Medicaid patients.

Crist is also proposing to streamline the process for building new hospitals by no longer requiring a "certificate of need," before a new facility can open. That idea, however, is opposed by Florida's hospitals who worry that new small doctor-owned facilities would siphon paying customers from hospitals, who need those patients to subsidize treatment of the uninsured.

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