Florida County Commissioners Meet To Discuss Fiscal Problems of Health Plan

Hillsborough County, Fla.'s indigent health care plan is "nearly broke," and county commissioners this week are looking into ways to fix the program, the St. Petersburg Times reports. The health plan was created in 1991 and is funded through a half-cent sales tax (Varian, St. Petersburg Times, 1/28). The plan covers county residents who do not qualify for other public health programs and have annual incomes up to 100% of the poverty level, or $8,590 for a single person and $17,650 for a family of four. The plan, a managed care plan, has more than 27,000 beneficiaries each year (Hillsborough County Health Plan Web site). When the health plan first began, revenues from the sales tax were so high that the plan was running a $155 million surplus, prompting county commissioners to cut the plan's funding in half. At the same time, the commissioners added new programs to the plan, including health services for prison inmates and children's health coverage. Those additions cost the health plan $16.1 million per year. Now, because of the added programs and rising costs of medical care, the plan's reserves are "nearly gone," the Times reports. Next year, costs for the health plan are expected to be $97 million, but revenue from the sales tax is expected to be only $81.5 million. To boost the plan's funding, county officials are considering shifting responsibility for the plan's costs directly to the county's budget and transferring money from a delay in road work to the plan. In addition, officials may limit the time beneficiaries can remain in the plan (Varian, St. Petersburg Times, 1/28). According to the Hillsborough County Health Plan Web site, about 70% of beneficiaries remain in the plan for only one year (Hillsborough County Health Plan Web site). Further, commissioners are considering limiting beneficiaries with catastrophic care needs to those with annual incomes at or below 100% of the poverty level. Now people needing such care are permitted to have incomes above the federal poverty line (Varian, St. Petersburg Times, 1/28). The commissioners will meet Jan. 30 to study recommendations from an advisory committee on how to cut benefits while doing the "least amount of damage" to the plan (Wexler, St. Petersburg Times, 1/29).

County Should Fund Plan
While shifting the plan's costs to other parts of the budget is appropriate, "[c]utting services, limiting enrollment and capping eligibility will further undermine" the county's safety net, a St. Petersburg Times editorial says. Noting that the health plan will continue to "teeter" on the edge of financial ruin without support from the county's general revenue fund, the editorial says the county should not push residents "further into poverty" when considering reform proposals. Doing so would only increase the number of families "forced to cope with medical and financial emergencies." The Times concludes: "The health plan is a useful tool that serves the needy and the taxpayers well" (St. Petersburg Times, 1/29).