The long-discussed Florida Health Choices program is moving forward with plans to run a health-insurance "marketplace" catering to small businesses, but its long-term future is more uncertain because of the federal health overhaul.
Sen. Aaron Bean, a Fernandina Beach Republican who is chairman of the state-created program, told board members Friday that the Florida Health Choices "mission has not changed." That involves serving as an online market for people to shop for insurance and other types of health coverage with more flexibility than in the traditional insurance system.
But Bean said questions center on part of the federal Affordable Care Act that requires operation of health-insurance exchanges in each state starting in January 2014. At least broadly, the exchanges are a similar concept to Florida Health Choices, but there are more restrictions on the insurance coverage that can be sold through the exchanges.
Also, the federal law, commonly known as Obamacare, requires most Americans to have health coverage in 2014 or face paying financial penalties. Some types of coverage sold through Florida Health Choices likely would not meet federal requirements, so people could wind up having to pay penalties if they buy coverage through the state program instead of the exchange.
"Eventually, down the road, we're going to have to sell what the federal government wants to sell,'' Bean said.
The federal exchange is a key part of the Affordable Care Act's strategy to dramatically expand the number of Americans who have health insurance. Depending on their income levels, millions of Americans will qualify for subsidies to help buy insurance through the exchanges.
Florida Republican leaders have not decided whether they want to operate an exchange. The other alternatives are to allow the federal government to run the exchange in Florida or to form a state-federal partnership.
Bean, who is chairman of the Senate Health Policy Committee, said Friday that the state is probably still months away from making a decision and, at least initially, that would mean defaulting to a federal-run exchange. He said one possibility that has been mentioned is for Florida Health Choices to eventually operate the exchange.
But Bean, who said the mission of Florida Health Choices is to spur competition and consumer choice, said the restrictions on what can sold in the exchange bring him "angst." Skeptics of Florida Health Choices, however, have long questioned whether the lack of requirements on what is sold in the state program could lead to consumers buying inadequate health coverage.
Florida Health Choices is expected to start selling coverage as early as next month. That would be nearly five years after lawmakers -- led by Bean and then-House Speaker and now-U.S. Sen. Marco Rubio -- approved the program's creation.
Small businesses, which in recent years have been stung by soaring health-insurance costs, would be able to sign up with Florida Health Choices. Their employees would be able to use the online marketplace to shop for coverage.
Bean and former Sen. Durell Peaden, who also serves on the Florida Health Choices board, raised the possibility that the program could shift focus in the future. As an example, Bean said it could find a niche in selling dental coverage.