The state of Florida is currently preparing its own health insurance exchange program in place of the exchanges created by the federal health care reform law, but according to Kaiser Health News, Florida’s exchange program is missing subsidies for low-income people to afford health insurance and requirements that insurance providers cover certain “essential health benefits.”

Florida is currently leading the fight against the federal health care reform law. The state has appealed to the U.S. Supreme Court to rule on the constitutionality of the law.

Leading up to the ruling, however, Florida has been thwarting the implementation of the Affordable Care Act in the state since its passage. According to research by the Center on Budget and Policy Priorities, Florida is one of only five states returning grants awarded by the federal government to implement the state exchanges, as well as a slew of other grants meant to assist low-income or at-risk communities in the state.

Florida is forced to create its own health insurance exchange or risk ceding its authority to the federal government. A provision in the Affordable Care Act requires that states implement their own programs — otherwise, the federal government will step in and take over implementation.

While Florida has taken this provision seriously, the state’s exchange program misses key parts of the federal exchange programs.

Kaiser Health News reports:

Florida’s version aims to give small businesses – those with 50 or fewer employees – an online tool where they can easily shop for health plans offered in their county. The idea, backers say, is to entice employers who otherwise wouldn’t bother to offer coverage.

Florida would be the third state – and by far the largest — with an insurance exchange, following Massachusetts and Utah. The Florida program is a public-private partnership.

But there are key differences between Florida’s exchange and the type that will be available in 2014 in all states through the federal law:

–Florida’s exchange is open only to small employers, not to individuals.

–The federal law provides subsidies to help lower-income individuals buy coverage through the exchange, and tax credits to some small businesses that cover their workers. Florida does not.

–The federal law requires health plans to offer certain “essential health benefits.” Florida does not.

Participation in Florida’s exchange is voluntary for both insurers and small businesses. But it is drawing only tepid support from health plans and insurance agents. That’s because both would pay a price for participating: Health plans would pay the exchange 2 percent of the premium for every policy sold through the exchange, and agents would pay $300 a year to sell policies through the exchange.

Ken Stevenson, a Tallahassee, Fla., insurance agent, says these extra costs, which would likely be passed on to employers, could end up making health coverage in Florida’s exchange more expensive than policies sold outside it.

“It defeats the whole purpose of having this,” he said.

In 2010, Florida had the third highest percentage of residents without insurance, according to the most recent U.S. Census. The 2010 Census information (.xls) finds that in a three-year average from 2008 to 2010, Florida’s percentage of uninsured people was 20.7 percent. The national average for uninsured citizens was 15.6 percent.

No state as large as Florida, or one with a comparable rate of uninsured, is attempting to create its own state health insurance exchange.

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