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Comparing the Bean and Negron alternatives to Medicaid expansion

Sen. Aaron Bean has come up with a bare-bones approach to helping Florida's uninsured that he hopes his colleagues in both the Senate and the House will rally around.

The proposal, SB 7144, is one of two alternatives to Medicaid expansion up for debate in the Senate. The other, SB 1816 by Sen. Joe Negron, has already received the support of senators, Gov. Rick Scott and the medical community. But it could be a tough sell in the House because it requires Florida to accept roughly $55 billion in federal aid.

Bean's plan will be formally introduced during Tuesday's Health Policy Committee meeting. As a primer, here is a comparison of the two proposals.

In a nutshell

Negron plan: Creates a new state-based health insurance program for the uninsured. Appears to comply with the federal health care law, making Florida eligible to receive associated funding.

Bean plan: Creates a state program to help the uninsured pay for various health care options by subsidizing the costs. Does not appear to comply with the federal health care law, meaning Florida would not be eligible for associated funding.

What it's called

Negron plan: Healthy Florida program

Bean plan: Health Choice Plus program

Who it is for

Negron plan: Any adults who make less than 138 percent of the federal poverty level, or $15,586 for a single person. This is the same population intended to be included in Medicaid expansion under the health care law. Roughly 1 million people would be eligible.

Bean plan: Any adults who make less than 100 percent of the federal poverty level, or $11,490 for a single person. (People making between 100 and 138 percent of the poverty line would be eligible for health subsidizes on the exchange, which is why Bean's plan doesn't include them.) Roughly 600,000 are eligible, but Bean doesn't expect his plan will be able to help them all.

Who would run it

Negron plan: Florida Healthy Kids Corporation would have a revised mission to include adults instead of just children.

Bean plan: Florida Health Choices would have a revised mission to allow individuals to shop for a variety of health coverages and plans, instead of just small businesses looking for insurance.

Who pays for it

Negron plan: Accepts federal Medicaid expansion dollars, estimated at $55 billion in the first 10 years. For the first three years, the federal government would pick up nearly all of the costs and up to 90 percent in future years. Enrollees would pay premiums and minimal co-pays for doctor visits. Using Healthy Kids as the model, premiums would be $15 to $20 and co-pays $10 or less.

Bean plan: Would mostly be paid for using state general revenue funds. Cost estimates haven't been finalized, but Bean told the Times/Herald he estimates about $30 to $40 million a year would help roughly half of the eligible people. Enrollees would pay at least $20 a month for their plans and the state's subsidy would be about $10 a month. 

What's the status

Negron plan: Has been assigned to two committees but hasn't yet but scheduled for a hearing.

Bean plan: He will ask the Health Policy committee to agree to introduce the bill. If that happens, it will be assigned committees as well.