Florida Matters: Health Insurance Changes For 2016

Nov 17, 2015
Originally published on November 17, 2015 3:36 pm

Enrollment is under way for plans on HealthCare.gov for the third year, and consumers are seeing many changes in the plans companies are offering. It’s not unlike what’s happening to employer-based insurance, which is how about half of all Americans get health care coverage.

This week on Florida Matters (Tuesday, Nov. 17 at 6:30 p.m. and Sunday, Nov. 22 at 6:30 p.m.), we talk about narrowing provider networks, increasing out-of-pocket costs and the challenges of finding the uninsured in a state that has led in sign-ups under the Affordable Care Act.

We are joined by Florida Covering Kids & Families Program Director Jodi Ray, Tampa health insurance agent Eric Brown and WUSF News Director and Health News Florida Editor Mary Shedden.

JODI RAY: Now (in year three), we really have to focus on those folks that don’t necessarily get their information in the most traditional ways, and folks that need their information in other languages. Maybe they’re not sitting on the Internet all the time, or those young adults that have a tendency to be resistant to seeing the value in having health insurance, so we really have to push the messaging out that those are folks that need it more than ever.

They have special needs that as growing adults could be met by having health care coverage, those preventive services are going to be really important to those young adults that are starting out on their own that don’t necessarily have those stable incomes, where an unexpected health care issue could really dismantle their stability financially.

CARSON COOPER:  Now, Eric Brown, President Barack Obama told WUSF News that it’s becoming more difficult to find people who are uninsured, and admittedly, there are a lot more people with insurance these days.  But do you sense that might be the reason? You can’t sign up more people because most people have already signed up for something.

ERIC BROWN: I see the biggest issues is education. What happens is, I was talking to one of the major health carriers here in Florida, and their premiums went up over 10 percent, and I asked them why. And they said because now, people now with major medical insurance are still using the emergency room, and that drives up cost when that occurs.  

So I said, 'Well, what are you going to do about it?' He said, 'Well, we’re just going to raise the premiums, and we’re going to not offer as many plans as we did last year.' I said, 'Well, to me, that’s an opportunity to educate people about what they have, and how to use it, versus raising the premiums again.' 

So, I see education, not just on the individual side, also on group health insurance. Same thing. Employers – one of their major difficulties is when they offer plans to their employees, the employees don’t understand what they have, and lots of times, when it’s time for them to use the plan, they’ll end up having financial problems because they don’t what they purchased at the time.

COOPER: Mary Shedden?

MARY SHEDDEN: The key question, I think, for consumers -- the people getting the plans --  is sometimes we’re not getting options. Maybe our company is giving us what we have. I think the thing you need to be asking is questions, not just at enrollment time. Many folks right now in employer-based plans, they’ve already signed up for the coming year, but I think it’s really important to be engaged throughout the year, especially when you’re dealing with out-of-pocket costs.

Those deductibles – I think more and more people are just assuming, oh, I’m going to get this procedure here. I think consumers need to be really aware that the insurance providers, they’re trying to make the math work. And because of that, there are changes and you need to make sure your practitioner is covered (and that) the treatment is the best cost option for you.

If you can’t afford a $2,000 MRI, you need to make a few phone calls before you get that procedure done. ...I think the best thing that’s happened since the Affordable Care Act came out. I think consumers across the board are smarter, but they need to get even more educated.