Senate Panel Punts Health Compliance Issues To Feds But Approves Coverage For OPS State Workers

Mar 18, 2013

Florida lawmakers are going through state health insurance laws trying to make sure they match up with new federal regulations.  Sen. Joe Negron (R-Palm City), Chairman of the Senate Committee charged with evaluating the health law, says the state shouldn’t be blamed if health insurance premiums increase because of the law.

“We don’t know the implication of all aspects of the law right now. I think it would be more prudent for OIR [Office of Insurance Regulation] to monitor those keep an eye on it. And maybe down the road if we want to get back down the road with rate setting for health insurance...but temporarily, while we’re in the transition period, it would be the federal government’s responsibility to make sure reasonable rates are being charged.”  

Conflicting state and federal laws mean headaches for insurers trying to comply with two sets of rules. And Michael Garner, President of the Florida Association of Health Plans, says it would be better for everyone if the state streamlined its regulations to mesh with federal ones:

“There are a number of things that are really critical but we really appreciate this committee, the legislature and the governor working with us to make sure we’re able to comply with the federal requirements we have to deal with while at the same time continue to protect Floridians under our current protections that you’ve built through regulations," he said.

Garner says state and federal rules differ in several areas. For example Florida’s laws governing health plan costs based on age allow higher rates than those under the federal Affordable Care Act. In this case the state would go with the federal governments rules, in order for insurers to make sure their products appear on federal insurance exchanges which will become a major purchasing vehicle for consumers.

“We are going to have to comply with that in order to offer our products to become qualified health plans that will be offered on the exchanges and outside of the exhanges.”

Under the proposal, the state’s Office of Insurance Regulation, OIR, would still be responsible for reporting violations to the federal government. The Senate panel is also recommending Florida extend health coverage to an additional 9,800 hourly state workers. Under the health law, if the state chose not to do it, it would be fined. And Negron says the extension of coverage makes financial sense:

“The penalty would be $318 million. The cost to provide insurance is $137 million...so my recommendation would be to recommend to the President to provide health insurance to the OPS staff.”  

But there could be a catch. Florida’s state health insurance plan may be subject to a tax, because it offers generous benefits with low deductables. Negron says the state may have to scale back on those benefits.  The House has already approved similar moves for state employees and the insurance regulator. Both chambers are crafting bills to implement the policies. It’s the latest decision in a string of moves the state has taken to comply with the federal Affordable Care Act.