Health & Science
8:03 pm
Tue April 2, 2013

BeanCare, NegronCare, Who Cares? Senate Panel Clears Another Alternative to Medicaid

A “Plan C” alternative to expanding Medicaid under the federal health law is now moving through the Senate. The proposal by Republican Senator Aaron Bean, cleared its first committee on a party line vote.

"BeanCare" would provide bare-bones health insurance plans to people at or below 100-percent of the federal poverty level, $11,500 for an individual. That’s 600,000 Floridians, half of number that would have been covered had the state expanded Medicaid under the Affordable Care Act. It’s the latest alternative to that expansion to be released. Bean says he’s just trying to come up an option lawmakers can agree on to increase health insurance coverage to the uninsured:

“It may not be your first choice, but it will be a choice as we move forward," he said.

The plan addresses those who make too much money to qualify for traditional Medicaid, but can't afford private health insurance.

Bean’s plan doesn’t rely on federal money. Instead, consumers would be steered into the state’s own small business insurance marketplace, called Florida Health Choices. It’s not yet operational. People would pay $20 a month into a health savings account which could be used to pay premiums and co-pays in bare bones health plans sold on Florida Health Choices. For example: a plan that provides access to local health clinics, or one that provides pharmacy benefits. But that doesn’t sit well with Democrats.

“I want to know why a person living at an income below poverty, would chose to pay the $20/month you have in this bill and jump through multiple requirements to get the same services they can receive now?” Asked Democratic Senator Arthenia Joyner.

Bean says he knows it’s a tough sell, but the program comes with other benefits as well. The “Florida Healthy Choices” proposal would be subject to legislative appropriations. And if lawmakers don’t fund it, no one gets covered.  Lobbyist Karen Woodall says she appreciative of Bean’s effort, but she can’t support leaving more than $50 billion of federal Medicaid support on the table.

“And it’s one of the principals of getting to “yes” that we believe is very important.  The other concern is in limiting coverage to those under poverty," Woodall said in public testimony before the Senate Health Policy Committee.

"And I understand the rationale that those up to 138 percent would be eligible for exchange subsidies, but that’s still a very low income, and those subsidies,we fear, will be unaffordable for those folks.”  

Hospital and business groups and even Governor Rick Scott supported expanding Medicaid. They’ve all also expressed some level of support for a more popular alternative by fellow Republican Senator Joe Negron, which would cover some 1.2 million Floridians who would have otherwise been eligible for the Medicaid expansion.

"NegronCare", as its been dubbed,  steers those people into the state’s long-established KidCare program, where they’d gain insurance. Senate Democrats and Republicans have endorsed Negron’s plan, which would allow Florida to draw down federal Medicaid money to fund the extra people. But as Bean points out, it takes three groups to get to yes. And that’s the House, Senate and Governor. Governor Rick Scott was asked whether he’d sign on alternative. Scott says he hasn’t seen either proposal yet.

“The President’s law is not a bill I supported. But it’s the law of the land. And while the federal government is going to fund 100-percent of it, I can’t, in good conscience, deny access to healthcare to Floridians who can’t get it.”  

Both plans would still have to get through the more conservative House, which isn’t keen on accepting federal Medicaid dollars. Bean’s proposal, while not as favorable in the Senate, still cleared its first committee on a party-line vote. And it could be more favorable to those like House Speaker Will Weatherford who says his chamber plans to come up with yet another alternative.