Florida Reboots Defunct Health Exchange for the Gig Economy

Florida is advancing legislation to create the Florida Employee Health Choices Program, a state-run marketplace for employees to use tax-free employer health funds, reviving a concept that failed nearly a decade ago.

• Second time's the charm?: The initiative reboots the statutory bones of the state's defunct 'Florida Health Choices' marketplace, which flopped after 2014 due to low enrollment and its inability to compete with HealthCare.gov.

• The price of entry: A new nonprofit will run the program, propped up by the Department of Management Services until it must become self-sustaining by 2029. An official analysis pegs the startup cost at $1.25 million.

• A subsidy showdown: The move has drawn scrutiny since private platforms for managing these health reimbursement arrangements already exist. The core tension lies with the Affordable Care Act: an 'affordable' offer from an employer disqualifies that employee from receiving federal subsidies, which could be a much better deal.

Florida is betting it can succeed where it failed before, but the program's real test will be whether it offers a better deal than the private market or the federal exchange it once lost to. Elsewhere, the Florida legislature is also considering a bill to create an interstate compact for social workers, making it easier for them to practice across state lines and via telehealth.