Gov. Charlie Crist touts Cover Florida healthcare plan as `national model’ despite its failings

Aug 10, 2009

The following story was published in the Miami Herald on August 9, 2009


Herald/Times Tallahassee Bureau

A success rate of less than a tenth of a percent might not sound like much, but to Gov. Charlie Crist it’s campaign-trail bragging material for healthcare reform.

Crist’s new Cover Florida healthcare proposal has signed up only 3,757 people in a state with nearly four million uninsured. Meantime, an estimated 77,250 Floridians have lost health-insurance coverage since Cover Florida began releasing statistics in March.

Yet Crist touts Cover Florida as a ”national model” and as a private-sector alternative to the government-run insurance plans of congressional Democrats and President Barack Obama. ”What’s happening in Washington, I don’t agree with,” Crist said recently. ”We found a better way in Florida, by wanting to include the private sector to participate more.”

Under Cover Florida, Crist’s administration persuaded insurance companies to offer stripped-down health plans for stripped down prices. The more coverage a person receives, the more he pays. That, Crist says, gives consumers more choice and less government.

Crist’s government-is-the-problem tone, which has become more pronounced as he began stumping for U.S. Senate, contrasts sharply with the approach he took to stabilize insurance rates on homes, businesses and other properties in 2007.

Then, Crist advocated for more government-run insurance to compete with private hurricane insurance companies as they raised rates and dropped customers. Now, Crist opposes government-run insurance, while health-insurance companies are raising rates and dropping customers.

At least one-fifth of Florida’s population lacks health coverage. Florida’s uninsured rate is the third-highest in a nation where about 50 million people are uninsured, according to the latest U.S. Census figures.

Crist argues that health insurance costs are so high in Florida because state government requires insurers to guarantee expensive procedures and lengthy hospital stays. By lifting some mandates, the government allowed six insurance companies to offer less expensive Cover Florida plans.

But since the government still helps ration benefits in Cover Florida, some question the conservative bonafides of Crist’s plan, which is outlined on the website

Two types of plans are available, catastrophic and preventive. Some plans have average premiums as low $50 a month. Others have deductibles as high as $5,000.

But for some Floridians, the costs might still be too high. For others, the limited services might not be worth the price, said R. Paul Duncan, a professor and director of the University of Florida’s Department of Health Services Research, Management and Policy. ”Part of the problem is that when people think about insurance, they think about comprehensive coverage,” Duncan said. ”So when they see limited coverage to accomplish a price reduction, they add it up and say, ‘I don’t think so . . . If I’m going to buy insurance, I want it to completely cover me.’ ”


But Duncan says Cover Florida deserves some credit, noting: ”If people are going from nothing to something, that’s better than nothing.”

Crist says his proposals became instant successes the moment they helped one person.

Crist’s campaign website gives scant indication of the limited enrollment in Cover Florida. ”I signed into law a nationally recognized, market-based health care program to provide low-cost health insurance for nearly four million uninsured Floridians,” it says. In an Aug. 5 ”special message” e-mail to supporters, Crist boasted about Cover Florida as well as the Florida Discount Drug Card program, which he says has saved 100,000 people a total of $3.5 million on prescriptions since December 2007. Average savings: $35 a person.

Crist said he’s confident the programs will do better. ”I wish more people would sign up, but they probably will once they learn about it,” Crist said.

A major reason few people know about Cover Florida: Crist won’t spend to advertise it. That enables Crist to boast the plan won’t raise taxes — a criticism he levels at the Democrats’ plan.

But it’s not like Crist can’t get the word out. In 2008, he successfully barnstormed the state to win voter approval for his tax plan that has fallen short of its promise to revive the economy. Since May, his Senate campaign raised a record $4.3 million — enough to pay for weeks of television advertising.

Behind lawyers and the development industry, the health industry accounted for at least $433,000 of Crist’s contributors, none of whom was a Cover Florida insurance company, according to a Miami Herald/St. Petersburg Times analysis of his last fundraising quarter

Crist’s Republican U.S. Senate opponent, former Florida House Speaker Marco Rubio, said Cover Florida’s results are ”typical” of Crist. ”Cover Florida is window dressing, a cosmetic solution,” Rubio said, comparing the plan to Crist’s property tax-cut and insurance proposals. ”No one at the time took Cover Florida seriously when it was passed.”

Rubio often criticized many of Crist’s initiatives before voting for them and first clashed with Crist over health insurance in 2008.

As Crist pushed Cover Florida, Rubio advocated a rival concept to establish a nonprofit company, Florida Health Choices Corp., that would act as a human-resources department for small businesses and offer them an array of health services.

Under a compromise, both proposals were packaged together in one piece of legislation that Crist signed with much fanfare. Crist then took nine months to appoint the Florida Health Choices governing board, crippling the effort to get the program quickly off the ground.


Democrats and liberals say it’s time for more. They want the government to step in, noting that Medicaid, Medicare and Veterans Administration beneficiaries like their government-run insurance program.

Washington-based Families USA, a liberal consumer advocacy group, says a government plan will lower costs and improve healthcare. The nonprofit plans to release a study next week showing that health insurance costs have risen 3.7 percent while wages have stagnated in Florida.

Families USA also reports that more than 556,070 Floridians are projected to lose health coverage from January 2008 to December 2010. That’s a weekly average of 3,560 — almost equivalent to the entire Cover Florida population. ”That estimate is probably low,” said Families USA analyst Kim Bailey. She said Families USA based its projections on data from Congress’s research arm and didn’t factor in the number of unemployed people in Florida, which lost 392,000 jobs from June 2008 to June 2009.

Recent polls show that the public isn’t united behind any healthcare proposal. But nearly everyone is likely to agree with Crist on this point: ”I think we need to do a better job at providing healthcare for our fellow Americans and our fellow Floridians.”

Marc Caputo can be reached at Miami Herald staff writer Beth Reinhard and St. Petersburg Times researcher Connie Humburg contributed to this report.