Members of a state insurance advisory panel called Friday for legislation fixing a regulatory “family glitch” that can make health insurance unaffordable to dependents of employees of small businesses.
The Florida Health Insurance Advisory Board declined additional proposed recommendations, however — in part because of uncertainty about what Donald Trump and the Republican Congress would do about the Affordable Care Act.
Board member Bill Herrle, Florida director of the National Federation of Independent Business, asked Insurance Commissioner David Altmaier, who chairs the panel, to begin bracing for whatever changes might be in store.
Herrle noted suggestions that Congress might set the ACA, sometimes referred to as “Obamacare,” to expire following the 2018 elections, and come up with a replacement plan in the interim.
“While that sounds like a long time, that could leave Florida with potentially only one legislative session in which to account for these changes,” Herrle said.
“Many of which may be ministerial, but some of which will not be as simple as going back to pre-ACA Florida statutes and plugging them back in. The market has changed very much.”
Altmaier agreed, saying his Office of Insurance Regulation has already started studying the situation.
“I think it would be prudent on the board’s part to initiate some of these dialogs,” Altmaier said.
The panel advises state leaders about health insurance matters and includes representatives of the industry, business interests, and state agencies. It needs a consensus to send recommendations to the Legislature.
Members agreed only once Friday: On the family glitch.
Louisa McQueeney, who manages an ACA navigator project for Florida CHAIN in Boynton Beach, argued that small group plans sometimes don’t cover employees’ family members. Depending on how much the family earns, the dependents might not qualify for ACA premium subsidies.
Other proposals failed, including to make health savings accounts available through high-deductible plans requiring policyholders to pay high out-of-pocket expenses; and to repeal a state law offering coverage through small-group plans to employees’ dependents until age 30. The ACA covers them until age 26.
Another idea that didn’t get off the drawing board involved improving coverage for sufferers of “maple syrup urine” disease, a genetic malady. State law mandates coverage through age 24 — a level established years ago when patients frequently died young.
Now they can live much longer, but have trouble paying for the expensive drugs that help keep them alive.
Often, board members cited uncertainty about what Republicans in Washington would do to the health insurance market.
“There are undoubtedly going to be some changes, maybe some substantial changes to the marketplace and how it functions, said John Matthews, southeastern general counsel for UnitedHealthcare.
“I question the wisdom of us making firm statutory mandate recommendations in light of what could be rather substantial changes to the ACA in general,” Matthews said.