Amid widespread national debate about making changes in the health care system, a Florida House panel has backed a proposal that would create a state program offering an online exchange for buying individual health insurance.
The program would be tied to what are known as “individual coverage health reimbursement arrangements,” which involve workers making coverage choices and getting reimbursed by their employers. The arrangements have tax benefits.
The House Health Care Facilities & Systems Subcommittee on Tuesday voted 12-3 to approve the bill (HB 141), which that would create the Florida Employee Health Choices Program that would include the exchange.
Bill sponsor Taylor Yarkosky, R-Montverde, said the proposal seeks to address high insurance costs and limited choices for businesses and employees. He described it as a “free market bill” and said the state could get out ahead as “massive health care changes are absolutely coming.”
But some lawmakers questioned why a state program is needed when private exchanges exist for such coverage.
“You are reinventing the wheel,” Rep. Robin Bartleman, D-Weston, said. “These marketplaces exist already.”
The federal government’s HealthCare.gov website says individual coverage health reimbursement arrangements — shorthanded as ICHRAs — are “a way for employers to provide tax-free reimbursements to employees for qualified medical expenses up to a set annual amount, including monthly premiums and out-of-pocket costs, without offering traditional group health coverage. To use the funds, employees must have their own individual health insurance plan.”
Debate about health care changes nationally has ramped up in recent months, in part, because of battles between congressional Republicans and Democrats about extending enhanced COVID-era subsidies for people who get policies under the Affordable Care Act. A push by Democrats to extend the subsidies played a major role in this fall’s government shutdown — though they have not been extended.
Yarkosky’s bill and an identical Senate bill (SB 440), filed by Sen. Tom Leek, R-Ormond Beach, are proposed for consideration during the legislative session that will start in January.
A House staff analysis said the bill would lead to the state spending at least $1.25 million on expenses related to such things as contracting for development of the exchange.
Lawmakers in 2008 established a similarly named Florida Health Choices Program as a health coverage exchange for small employers. But the House staff analysis said the program “struggled to attract enough enrollees and enough products to support a diverse marketplace and be self-sustaining.”
Also, the analysis pointed to the subsequent development of a federal health-insurance exchange under the Affordable Care Act as helping leading to the demise of the state program.