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State employee health insurance costs, enrollment expected to surge under Affordable Care Act

In addition to wrangling with questions on whether to expanding Medicaid and create an exchange under the Affordable Care Act, Florida also is grappling with how the law will impact its own employee health plan.

There are between 160,000 and 170,000 employees in the state government, and Florida must abide by the components of the Patient Protection and Affordable Care Act that relate to large employers. The price tag could be as much as $410 million in 2014-2015, the first full year that many of the more costly provisions of the law are in effect.

The House Select Committee on PPACA received a report on the estimated impact of the Affordable Care Act on state employee insurance plans during today's meeting.

The biggest decision for Florida: whether to change state law so that OPS (other personal service) employees are eligible for health insurance. Under the Affordable Care Act, the state will either have to offer insurance to all of these contract workers who work at least 30 hours a week or pay a hefty fine.

In 2014-2015, it would cost Florida $44.3 million to provide insurance to OPS workers. But if the state refuses to do so, it would face a $318 million penalty. The state estimates that there are roughly 7,000 OPS employees, mostly workers at state universities.

Affordable Care Act provisions that allow young adults to remain on their parents’ insurance, eliminate lifetime caps, eliminating pre-existing condition limitations, and impose new fees and taxes are also increasing the state’s costs. In addition, the state expects more employees who currently opt out of the state health plan to enroll in order to avoid paying penalties under the individual mandate.

All together, the state could be on the hook for $137 million in Affordable Care Act-related costs in 2014-2015 if OPS employees are offered insurance. That amount would rise to $153.6 million in 2015-2016. Those amounts would be much higher if the state opts to pay the OPS fine instead.

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