Affordable Care Act

Four dozen health centers around the state that provide a medical home for uninsured low-income Floridians and for those who are newly insured through the Affordable Care Act will get a share of $13.4 million in federal funds, the U.S. Department of Health and Human Services announced Friday afternoon.

Most of the grants fell into the range of $150,000 to $400,000, but a few of them were for more:

·         Community Health of South Florida in Miami, about $507,000.

·         Manatee County Rural Health Services in Palmetto, about $499,000.

Family Premiums Rise Modestly: Survey

Sep 11, 2014

Premiums for job-based insurance rose modestly for the third consecutive year, reflecting slowed spending, even as key elements of the federal health care law went into effect.

Family premiums rose 3 percent in 2014, one of the lowest increases tracked since the Kaiser Family Foundation and the Health Research & Educational Trust began surveying employers in 1999. (Kaiser Health News is an editorially independent program of the foundation.)

Many people newly insured by Medicaid under the federal health care law are seeking treatment in hospital emergency rooms, one of the most expensive medical settings, a study released Monday concludes.

The analysis by the Colorado Hospital Association provides a real-time glimpse at how the nation’s newest social program is working.

It also found indications that newly insured Medicaid patients admitted to hospitals may be sicker than patients previously covered under the same program, which serves more than 60 million low-income and disabled people.

The federal appeals court in Washington threw out a ruling Thursday that called into question the subsidies that help millions of low- and middle-income people – including Floridians -- afford their premiums under the president's health care law.

The U.S. Circuit Court of Appeals for the District of Columbia granted an Obama administration request to have its full complement of judges re-hear a challenge to regulations that allow health insurance tax credits under the Affordable Care Act for consumers in all 50 states.

The nation's respite from troublesome health care inflation is ending, the government said Wednesday in a report that renews a crucial budget challenge for lawmakers, taxpayers, businesses and patients.

Economic recovery, an aging society, and more people insured under the new health care law are driving the long-term trend, according to the report published online by the journal Health Affairs.

More than 200,000 immigrants who bought insurance through President Barack Obama's health care initiative could lose their coverage this month if they don't submit proof this week they are legally in the country, but language barriers and computer glitches are hindering efforts to alert them.

The government mailed letters in English and Spanish last month notifying about 300,000 people that if immigration and citizenship documents aren't submitted by Friday, their coverage under the Affordable Care Act will end Sept. 30.

More than a third of likely Florida voters in a new Tampa Bay Times/Bay News 9/UF Bob Graham Center poll say they want the federal Affordable Care Act repealed entirely. As the Times reports, 37.3 percent of likely Florida voters want the law known as Obamacare gone, and 20.9 percent want to see “major changes” to it.

Complaints alleging that the Jackson Health System is barring Miami-Dade residents from the hospital’s charity care program have been filed with the Internal Revenue Service and U.S. Department of Health and Human Services, the Miami Herald reports.

Insurers can no longer reject customers with expensive medical conditions thanks to the health care overhaul. But consumer advocates warn that companies are still using wiggle room to discourage the sickest — and costliest — patients from enrolling.

Some insurers are excluding well-known cancer centers from the list of providers they cover under a plan; requiring patients to make large, initial payments for HIV medications; or delaying participation in public insurance exchanges created by the overhaul.

Health insurers want to raise rates in 2015 -- but Florida's insurance regulators are pretty much powerless to stop that.

And the Republican Party of Florida says that's Obamacare's fault.

Is that true?

While most Americans are required to obtain health insurance under Affordable Care Act’s mandate, others are exempt from purchasing insurance by joining medical bill-sharing groups, the Miami Herald reports.

FL Office of Insurance Regulation

Editor's Note: This story has been corrected regarding the way state and federal agencies report Affordable Care Act insurance enrollment . 

The number of Floridians enrolled in individual health plans under the Affordable Care Act in June was 866,485, according to new state data compiled from insurers’ reports. The carriers expect enrollment to rise to 1.1 million next year, an increase of 23 percent.

Pediatricians challenging how the state pays for Medicaid services to children could see the nine-year-old case end in October, the Miami Herald reports.

The lawsuit, filed in 2005, claims that the Agency for Health Care Administration, Department of Health and Department of Children and Families violated federal law, and also hampered patient access by making low Medicaid payments to providers, the Herald reports.

HMO, PPO, EPO: Which Plan Is Best?

Aug 19, 2014

What’s in a name? When it comes to health plans sold on the individual market, these days it’s often less than people think. The lines that distinguish HMOs, PPOs, EPOs and POS plans from one another have blurred, making it hard to know what you’re buying by name alone - assuming you're one of the few people who know what an EPO is in the first place.

“Now, there’s a lot of gray out there,” says Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms.

Florida looks to lose more federal money set aside for Medicaid than any state that has opted out of expanding the health care program for the poor, says a new report from the Robert Wood Johnson Foundation and the Urban Institute.

Hospitals May Help Pay ACA Premiums

Aug 14, 2014

Low-income consumers struggling to pay their premiums may soon be able to get help from their local hospital or United Way.

Some hospitals in Florida, New York and Wisconsin are exploring ways to help individuals and families pay their share of the costs of government-subsidized policies purchased though the health law’s marketplaces – at least partly to guarantee the hospitals get paid when the consumers seek care.

The clock is ticking for hundreds of thousands of people who have unresolved issues affecting their coverage under the new health care law. Florida has the most cases at 93,800.

The Obama administration said Tuesday that letters are going out to about 310,000 people whose citizenship or immigration details don't match what the government has on file. 

These consumers need to send in their documentation by Sept. 5. Otherwise their coverage will end Sept. 30.

FMA Supports Medicaid Expansion Money

Aug 6, 2014

I recently attended the Florida Medical Association annual meeting, where the organization develops policies for the coming year. The legislative agenda is drafted and approved.

FMA delegates from the specialty groups and county medical societies will vote on each resolution coming before the House. FMA lobbyists will then bring approved policy to Florida’s legislators and congressional representatives.

Advocates: FL Consumers to Pay for Lawmakers’ Decision

Aug 6, 2014

Republicans were quick to pounce Monday on Florida’s announcement that residents buying health insurance on the individual market for next year will face a 13.2 percent average increase in monthly premiums — one of the steepest rate hikes announced for any state. “Obamacare is a bad law that just seems to be getting worse,” said Florida Gov. Rick Scott, a Republican who is running for re-election.

  The Florida Medical Association's House of Delegates overwhelmingly adopted a resolution supporting Medicaid expansion to cover uninsured low-income adults at FMA's annual meeting on Sunday, according  to doctors who were there.

(Editor's note: This story has been updated with the statement from FMA.)

Insurers must pay $41.7 million in rebates to Florida individuals and employers this summer, an amount that far exceeds refunds in any other state, according to a federal report released Thursday. 

Companies affiliated with Florida Blue in Jacksonville -- Blue Cross and Blue Shield of Florida and Health Options Inc. -- owe a total of $20 million, nearly half of the total.

US Court of Appeals

An appeals court in Washington, D.C. issued a decision Tuesday that would wipe out an estimated $4.8 billion a year in subsidies to Florida individuals and families who signed up for a health plan on the federal health marketplace this year. That would make health insurance unaffordable to most of the nearly 1 million Floridians who enrolled.

A court case challenging the Affordable Care Act's subsidies for plans sold on the federal marketplace could have an outsize effect on Florida, according to a new analysis.

A ruling is expected any day on Halbig v Burwell from a three-judge panel of the U.S. Court of Appeals in Washington, D.C. If the government loses and further legal maneuvers fail, the 34 states that rely on the federal exchange would see a $36-billion loss of subsidies, three Urban Institute researchers project.

Lottie Watts

How much will it cost Floridians to buy coverage next year on Lots of people want to know, but the insurers are keeping the prices secret in an unprecedented way.

(Editor's note: This is a conversation between WUSF All Things Considered Host Craig Kopp and Health News Florida Editor Carol Gentry.)

Florida ranks last in the country in per-person funding from the Affordable Care Act, a new study shows, and that doesn’t even include the billions of dollars the state is forfeiting by saying no to Medicaid expansion.

The Center for Healthcare Research & Transformation at the University of Michigan performed the analysis of ACA grant totals between the time the law was signed in March 2010 and the end of September 2013.

Nearly 1 million Floridians have signed up for coverage via the Affordable Care Act (ACA), but some in South Florida are having to battle with doctors for treatment, the Miami Herald reports.

A lot more Floridians have health coverage compared to a year ago, but the state continues to have one of the nation’s highest uninsured rates, two new studies show.

An estimated 26 percent of working-age Floridians remain uninsured, according to a new Commonwealth Fund survey that looks at enrollment since the Affordable Care Act enrollment launched last October.

The White House will release a state-by-state report Wednesday which estimates that a Medicaid expansion in Florida would generate 63,800 jobs from 2014-2017.  Most of the jobs would be in health care, while providing health care to 848,000 people, according to the Tampa Bay Times.

The number of health insurers willing to compete in the federally run Health Insurance Marketplace for Florida enrollees for 2015 has grown, according to forms filed with a state agency by Friday's deadline. One that stayed out last year, giant UnitedHealthcare, is among them.

Orlando Health announced Wednesday that it is no longer seeking a partner for merger or acquisition because its own finances are healthy and there is no longer a need, the Orlando Sentinel reports.  While the not-for-profit health-care system had received several proposals, its board decided Monday to remain independent, a decision that goes against the nationwide trend of hospital mergers.  The board also decided to begin a national search for a new