Manatee health advocate presents plan to insure low-income residents

— When Ray Fusco talks, people tend to listen. At least people passionate about health care for the needy.

Fusco is a member of the Manatee Healthcare Advisory Board and the reason it seems to get quiet when he talks at meetings could be because he was an administrator at Manatee Memorial Hospital for 18 years and was chief operating officer at the former Manatee County Rural Health, where he helped galvanize that organization’s Medicare program.

Since January of this year, when the advisory board formed with the mission of coming up with a cost-effective plan for caring for the county’s uninsured, indigent population, Fusco has brought his years of experience into the board’s once-a-month discussions.

During the board’s 10th meeting, which was Wednesday night, Fusco presented an idea that won praise from many of his colleagues.

The “Fusco Plan” calls for helping members of Manatee’s uninsured and indigent population who do have some income to sign up for the Obamacare Silver Health Insurance. Manatee nonprofits would contribute money through donations to pay for both the monthly premiums of the Silver policies, which Fusco believes would be low based on client incomes, and the out-of-pocket deductibles.

Although he said the monthly rates may vary as to income and individual situations, they could be as little as $20 with an out-of-pocket deductible to meet of $2,500 annually.

“What happens with the health care exchange is that they adjust your premium rate based upon your income,” Fusco said after the meeting. “It could be that people down around 105 percent of poverty level would have their premiums around $20 per month for Silver. For the people in that very low level of poverty, between 100 and 150 percent, the Silver plan is good because not only is the cost of the premium very low, but the out of pocket is low. It’s only $2,500. The federal government picks up the rest.”

People on those plans receive care in hospitals because they have insurance, Fusco said.

“For a very low cost you, could assure they would be covered, and it wouldn’t come from the county,” Fusco said. “My suggestion would be that you would set up a 501c3 (nonprofit entity) that would accept donations to support this population, and they would see these people and assist them.”

Maybe even local hospitals could contribute to the plan, Fusco hinted.

“It’s beneficial, as I see it, to the high-cost providers like the hospitals, because if they end up in the hospital, the hospital will be able to bill,” Fusco said.

Board member Philip Brown said he and his fellow board members should explore Fusco’s plan in depth.

“What you are saying is that for people who are at 100 to 150 percent of the federal poverty line, the most effective way of helping them could be to pay for their Silver premiums, or a similar plan in the marketplace at about $20 per month,” Brown said during the meeting. “There could be many ways to pay for it. It could be that it would even be good use of our county dollars. It’s an idea, and it’s a good one.”

Board members, who are likely to discuss Fusco’s plan and other ideas at future meetings, are expected to attend an important 1:30 p.m. work session of the Manatee County Board of Commissioners Thursday.

At that meeting, consultant Maurice Lemon of Health Management Associates is expected to present his organization’s final report to commissioners.

Health Management Associates was contracted by the county to develop a health care model to provide services to the uninsured residents of Manatee County.

The work session is in the Manatee Room, on the fourth floor of the Manatee County Administration Center, in downtown Bradenton.

Besides Fusco and Brown, the advisory board consists of Beverly Hindenlang, Thomas Skoloda, Kirk Zeppi, Dominique Kohlenberger, Mildred Isom, Henry Raines, Ernest "Sandy" Marshall, Lori Dengler and Stephen Hall.

This story was originally published August 24, 2016 at 9:05 PM with the headline "Manatee health advocate presents plan to insure low-income residents."