Both Gov. Charlie Crist and fellow Republican House Speaker Marco Rubio of West Miami have made the issue a top priority, though they now have only four days left to reconcile basic differences in their plans that reflect basic differences in their styles:
• Crist's ''Cover Florida'' plan is simple and passed the Senate quietly and unanimously. It would offer individuals less-expensive health insurance in return for less-expansive coverage.
• Rubio's ''Florida Health Choices'' plan is more complex and passed on a party-line vote last week after Democrats forced a 16-hour slowdown. The plan borrows Cover Florida plans, and also creates a public-private corporation to act as a health-plan ''marketplace'' and human-resources department for small businesses.
Rubio and fellow House Republicans say they've scaled back their proposal, at Crist's insistence, to ensure it has more ''consumer protections.'' But they fear that could lead to ``over-regulation.''
Though a compromise product is likely, Rubio is preparing to scuttle the legislation if Health Choices isn't in the mix. That could gum-up the passage of other high-priority health bills and will certainly mean Florida will remain the state with the third-highest rate of uninsured in the nation.
''Our ideas are important,'' said Rubio, who offered up a variant of his plan in his ''100 Innovative Ideas for Florida's Future'' initiative. ``I want our plan to be passed. And the way I can ensure that our plan is made part of policy is to ensure that it's linked to the governor's plan.''
That decision is now up to the Senate, which is on Crist's side and is threatening to strip the House's Health Choices from the bill and send just Cover Florida back to the House for final passage. Echoing House Democrats and Crist's office, senators say Rubio's plan is too uncertain and expensive. It will cost more than $1 million to start up the House's ''marketplace'' corporation. Senators say they can't justify the cost in a year of $4 billion in budget cuts -- some of the heaviest of which are for social services.
UNPLEASANT
The bad budget and election-year politics have helped make the typically tense end-of-session atmosphere unusually unpleasant. And Crist has helped fuel hard feelings in the Florida House in a few press conferences to tout his plan.
Though Crist says he's offering ''encouragement,'' at two events the popular governor suggested lawmakers don't deserve re-election if his plan isn't approved, saying legislators promised constituents that they'll fight for them in Tallahassee.
''You damn sure better do it, or you won't be back,'' Crist said two weeks ago. In a follow-up news conference, he added that ''my heels aren't dug in'' but didn't like the time, money and bureaucracy that the House plan would require. Crist said Cover Florida plans could be ready by next year.
CORPORATION
Rubio said the two ideas aren't mutually exclusive. Where Crist just aims at individuals, the House further targets small businesses with fewer than 50 employees.
The marketplace corporation would negotiate with health providers to offer myriad plans, including stripped-down insurance packages, Wal-Mart-like ''minute clinics,'' and alternative-medicine proposals.
Acting as the businesses' HR department, the marketplace corporation would help employers file and fill out paperwork and help them define their contribution for employee-benefit packages. The corporation would collect the monthly premium, keep a percentage and remit the rest to the plan providers.
If a business selects a plan or plans, the employee could opt out and remain uninsured or pick one of the voluntary ''Cover Florida'' plans, which would be offered by just one or two companies.
`BOTTOM-FEEDERS'
Opponents say Rubio's plan doesn't have enough regulations to ensure that ''bottom-feeders'' don't rip off people. House Republicans say the plans will be financially sound, and counter that their opponents want more ''bureaucracy'' by insisting the state Office of Insurance Regulation have a greater say.
The tensions between the two sides are increasing as the 60-day session winds to a close Friday, and as the fate of priorities of legislative leaders get entwined.
The health insurance bill is tied up with Crist priorities to streamline the new-hospital approval process and to change dentistry rules. Added to that: competing health-insurance mandates for covering children with autism; more than a half-billion dollars in hospital and nursing-home reimbursement money; and Rubio's push to accelerate Medicaid reform in Miami-Dade and elsewhere, which the Senate is balking at.
Sen. Durell Peaden, a Crestview Republican who chairs the Senate's health budget committee, said the health plan ''symbolizes'' a lot of the tough feelings this year. And he said it it will get worse if the plan dies and Crist wields the ultimate tool of revenge for a governor: the veto pen.
`BULL-HEADEDNESS'
''And then everybody suffers because of somebody's bull-headedness,'' Peaden said. ``I'm getting my blood pressure up: [House leaders] want to start a bureaucracy that we just don't need, that just costs more.''
Peaden's counterpart in the House, Republican Aaron Bean of Fernandina Beach, said the $1 million for the marketplace corporation ''is nothing in the healthcare budget,'' which stands at $22 billion this year.
Lawmakers often compromise at session's end, so the back-and-forth is to be expected as term limits force legislators from office. And that could cause Rubio and Senate President Ken Pruitt and their top deputies to lose sight of what's important, said Miami Republican Sen. Alex Diaz de la Portilla.
''They really have less than a week of political relevancy left,'' he said. ``What to the outside observer may look like a petty issue, it gets magnified under this pressure. And all of a sudden it becomes about who wins and who loses rather than the issue itself.''
