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Florida Misses Target To Outline Benefits Under Healthcare Overhaul Law

The target date for states to spell out what benefits health insurance companies have to offer under the healthcare overhaul law was Monday. And Florida officials didn’t submit a plan. Now the state may be “defaulting” into a package that’s already available, and its one that most state employers and small businesses already offer.

Florida Blue is the state’s largest small group insurance provider and if the state refuses to act, Florida Blue’s insurance plan could set the bar for what most other insurance companies in the state will have to offer consumers.

“Blue options is what most state employees have so we have experience with that product,”  said Laura Goodhue, Executive Director of the healthcare consumer group Florida CHAIN.

The group released a white paper on the "Essential Benefits" under the federal Affordable Care Act and Florida Blue's role as the default option.

Goodhue says if Florida Blue becomes the benchmark plan, most people won’t see much of a difference in their healthcare coverage, but she's still worried about consumers not getting a say regardless of what the state chooses to do.

“Our concern is whether or not the state will take action without Floridians being able to have input into that process.” 

As it is now, Florida Blue isn’t a perfect fit to meet the federal government’s minimum insurance levels. And one area the plan is lacking is in children’s health services. The Florida Pediatric Association has tried to get a meeting with the state to discuss the issue, but was rejected because it’s currentlysuing the state. says he’d like to see the state raise coverage levels for children in insurance plans sold in Florida.

“As experts in child healthcare, we feel members of our organization should be available to advise the state about an appropriate benefit package which the states are mandated to develop as part of the affordable care act," said Dr. Louis St. Petery, Executive Director of the Florida Pediatric Association.

While Florida officials have yet to submit plans for choosing insurance benefits that doesn’t mean they won’t. The state wrote a letter to the federal government on Friday requesting more information on the benefit rules, and in a statement, a U.S. Department of Health and Human Services official says the agency is willing to work with states that submit plans later on. About 16 other states have already submitted benefit plans.

For more news updates, follow Lynn Hatter on twitter @HatterLynn.

Follow @HatterLynn

Lynn Hatter is a Florida A&M University graduate with a bachelor’s degree in journalism. Lynn has served as reporter/producer for WFSU since 2007 with education and health care issues as her key coverage areas.  She is an award-winning member of the Capital Press Corps and has participated in the NPR Kaiser Health News Reporting Partnership and NPR Education Initiative. 

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