Miami-Dade County

Feds tell PR firm not to promote Florida health exchange

Applicants line up outside the Sunshine Life & Health Advisors at a store setup in the Mall of the Americas on December 15, 2014 in Miami.
Applicants line up outside the Sunshine Life & Health Advisors at a store setup in the Mall of the Americas on December 15, 2014 in Miami. Miami Herald

The federal government has told Tallahassee-based public relations firm Salter Mitchell that it cannot promote the state’s health insurance marketplace, a long-time client, because of a conflict of interest, according to the state and the firm.

Salter Mitchell also works for the federal Centers for Medicare & Medicaid Services, which administer, the federally run healthcare exchange.

The firm relayed the federal decision to Florida last month, saying that it would not be able to market the state exchange during the open enrollment period, from Nov. 15 to Feb. 15, when Americans can sign up for health coverage under the Affordable Care Act.

The conflict arose because, starting in January, the state exchange will for the first time sell comprehensive health plans compliant with the ACA, although it will not offer subsidies as does.

Rose Naff, CEO of Florida Health Choices, said that federal government’s action, with its implication that the state exchange would compete with, seemed “counter-intuitive.

“Their target market is individuals who qualify for federal subsidies. We’re going after Floridians who don’t need a subsidy. It would make no sense for us to compete with in that sense,” Naff said.

Gov. Rick Scott has sparred with the Obama administration over the health law. State legislators have so far refused to use about $5 billion in federal funds to expand Medicaid to an estimated 760,000 uninsured Floridians.

A coalition of business interests and private citizens recently floated an alternate proposal, which is gaining traction among state leaders, that would allow Florida to expand Medicaid.

CMS spokesman Aaron Albright wouldn’t comment on the conflict of interest decision.

CMS had a contractual right to intervene, said Peter Mitchell, chairman of Salter Mitchell.

“Anytime we’re doing work on one account that might overlap with another, we take it to the client,” he said. “And CMS felt since Florida Health Choices was moving into comprehensive health plans that it presented a conflict to do promotional work for them.”

State Sen. Rene Garcia, a Miami Republican who chairs the Senate subcommittee on health appropriations, was not surprised to learn the federal government had intervened.

“It makes sense to me,” he said. “If you look at it, you can see a conflict of interest.”

Rep. Jason Brodeur, a Sanford Republican who chairs the House Health and Human Services Committee, said he understood Naff’s frustrations but characterized the issue as “minor.”

“I don’t interpret it as the feds trying to poke us with a hot stick in the eye,” he said.

Salter Mitchell, which also has offices in Washington, D.C., and Orlando, has worked for CMS since 2010 researching consumer attitudes toward health insurance. The firm has won more than $7.4 million in contracts from the federal government, according to, a public database.

The state exchange hired the firm in 2011. CMS will allow Salter Mitchell to continue helping the state exchange design its website and logo, Mitchell said.

In the past, the state exchange sold only limited benefit and discount plans that offered dental, vision, prescription and other services. U.S. Sen. Marco Rubio, then speaker of the Florida House, helped create the exchange in 2008 as a voluntary marketplace for consumers to obtain health insurance.

Only 49 people signed up for plans with the state last year, despite a budget of almost $800,000. Nearly a million Floridians signed up for comprehensive coverage on the federal marketplace.

Naff said the state had hired another Tallahassee firm, On 3 Public Relations, to lead a $75,000 marketing campaign until the end of open enrollment on Feb. 15. The state exchange also has hired about two dozen insurance agents to operate a call center in Jacksonville, according to Naff.

“Maybe we’re overstaffed but we don’t want to have hold times,” Naff said. “We don’t want someone’s first experience with us to be a busy signal.”

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This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.