According to the 2010 Census, 16.7 percent of all Americans do not have health insurance. Of this population, six in 10 uninsured households have at least one adult working full time, per the Kaiser Family Foundation.
With the average cost of single-coverage health insurance at $5,615 per year in the United States, and $15,745 for family coverage, many low-income families must decide if their budgets can absorb such a financial shock — if their employers offered health benefits in the first place.
On Jan. 1, 2014, the Patient Protection and Affordable Care Act (PPACA) will go into full effect. Under PPACA, Medicaid eligibility will be expanded to all adults with an income up to 133 percent of the poverty line in participating states, health insurance exchanges will be established to offer coverage for the uninsured with incomes that fall between 133 and 400 percent of the federal poverty line, small businesses will receive tax credits to offset the cost of employer-subsidized insurance and employers with more than 50 employees will be fined for not offering health coverage to all full-time employees.
But for many Americans, health insurance is — government intervention notwithstanding — the difference between eating and not eating, between having warm clothing and having to make do, between making rent and not making rent. The idea of paying premiums in a perpetually cashless environment — of choosing between seeing a doctor when needed and feeding your kids — is unimaginable, particularly, for a group of Florida legislators.
Members of the Florida House only pay $8.34 a month for individual health care coverage, or $30 a month to cover their family. That’s just a third of what these same legislators are asking the poorest Floridians to pay.
Insuring the poor in Florida
In April, the Republican-controlled House passed its health coverage plan. The House bill would cover only one-tenth of the 1.1 million Floridians covered by the Florida Senate Republicans’ plan and would not accept any PPACA funding. The bill only would extend coverage to residents at or below the federal poverty level; these households would receive $2,000 a year from the state to choose their own private insurance plan.
The offered plans would have an additional $25 monthly premium and in all likelihood, high deductibles, making them unaffordable to many poor families, in the eyes of the Democrats. The plans also only would cover basic medical care and would provide a limited number of hospital visits.
“There’s very little you can buy,” said Rep. Mia Jones (D-Jacksonville). “This population will not be able to take this product that has been crafted for them and not be able to do anything of value with it.”
The Senate plan would take $50 billion in PPACA money over the next decade and create vouchers for the 1.1 million Floridians at or below 133 percent of the federal poverty line in order to purchase their own private health insurance.
The perks of power
The discrepancy between what the House membership is asked to pay for health insurance and what is asked of the poorest Floridians — or even other state employees — has put Florida’s Republicans in an awkward and embarrassing position.
Florida House Speaker Will Weatherford (R-Wesley Chapel) said in a statement, «We are aware of the differences in what House members pay compared to other state employees for health insurance and are looking forward to addressing it next session.»
Many see this as a clear double standard. “I don’t think there is a defense of that. I think it’s pretty unconscionable,» said Karen Woodall, executive director of the left-leaning Florida Center for Economic and Fiscal Policy. «And then to turn around and the leadership to say the reason 1 million people aren’t accessing taxpayer-funded health care is they don’t want to use taxpayer dollars is very disingenuous.”
Florida heavily subsidizes the cost of health care for all state employees. But the 24,000 supervisors and managers in state government receive extra subsidization, creating a nearly premium-free health insurance plan for those on top.
While the House opted to keep itself within this classification, the Senate moved to be lowered to the health insurance plan most state employees enjoy. State senators pay $50 per month for health insurance for single coverage and $180 per month for family coverage.
House members, who are considered part-time employees and receive $29,697 per year, have the same level of coverage as other state employees, but at a lower upfront cost. It costs Florida taxpayers $600 per month to insure each House member. All but 12 House members are enrolled in the health plan.
Florida is far from alone from having state health insurance programs for their legislators beyond what is available for the poor. Montana legislators — considered quarter-time state employees — receive a health insurance subsidy of $733 per month — regardless of whether they are enrolled in the state insurance. In Tennessee, 80 percent of state legislators’ health insurance premiums are covered by the state. Pennsylvania legislators pay 1 percent of their salaries to health insurance, compared with the 2 percent the average Pennsylvanian contributes.
Alabama, Alaska, Delaware, Florida, Iowa, Kentucky, Maine, Minnesota, North Carolina, North Dakota, Oklahoma, Oregon, South Dakota and Texas offered 100 percent state-paid individual health insurance coverage to some or all of its state employees in 2010, and Alaska, Delaware, Iowa, North Carolina, North Dakota, Oklahoma and Oregon offered 100 percent paid family coverage for at least some families of state employees.
As state employees, state legislators would be eligible for the same or better health insurance rates than what would be offered to other state employees. Wyoming and South Dakota, by contrast, do not offer health insurance to legislators.
Florida Rep. Richard Corcoran (R-Land O’Lakes), who authored the Florida House’s PPACA alternative, argues that what legislators pay for health insurance should not be the focus of the discussion. «I think the entire state health care system is broken, and what we tried to do is try to fix it,» Corcoran said, noting that conservatives have called his proposal a national model. «When you do that, everybody is going to be treated equally and fairly.»