Affordable Care Act

Hospitals Taking Cues From Hospitality

Nov 5, 2014

Two years ago, Inova Health System recruited a top executive who was not a physician, had never worked in hospital administration and barely knew the difference between Medicare and Medicaid.

What Paul Westbrook specialized in was customer service. His background is in the hotel business – Marriott and The Ritz-Carlton, to be precise.

What a difference a year makes.

The nation’s biggest health insurers entered last fall cautious about a major coverage expansion initiated by the health care overhaul, the federal law that aims to cover millions of uninsured people.

Investors and company executives were worried because they didn’t know how expensive new customers from the overhaul would be for insurers. They also were concerned about added costs from the law and funding cuts to government-sponsored Medicare Advantage plans, a key growth area.

Healthcare.gov

  More than 200,000 Floridians are projected to sign up for health insurance during the upcoming Affordable Care Act enrollment period beginning November 15th, the Miami Herald reports.

The projection, compiled by the Florida Office of Insurance Regulation, would raise Florida's total enrollment to about 1,07 million, the Herald reports.

Some Southern States Expanding Medicaid

Oct 30, 2014
The University of Arkansas

The University of Kentucky’s Chandler Hospital has seen its inpatient numbers rise by 5 percent and its outpatient numbers rise by 10 percent since July. But its number of uninsured patients has dropped, from about 9 percent to 2.5 percent.

Prior to this year, says Chandler’s Dr. Michael Karpf, “we were getting paid 10 cents on the dollar” serving low-income patients. “Now we are getting 40 cents on the dollar, so the cost of care for these people isn’t totally covered, but there is a lot more reimbursement. It means we are having very strong bottom lines in the hospital.”

While the Affordable Care Act offers insurance for people living with HIV/AIDS, the plans could be too costly, the Miami Herald reports. Prices for 2015 plans won’t be announced until at least next week, but some Floridians won’t be surprised if they can’t afford it, the Herald reports.

HealthCare.Gov EZ Form Not for Immigrants

Oct 27, 2014
CuidadoDeSalud.gov

HealthCare.gov's simpler online application is being touted as a big win for consumers. But it can't be used by immigrants in the United States legally and naturalized U.S. citizens, who represent millions of potential new health insurance customers.

That's prompting worries that many Hispanics and Asians will end up in long enrollment queues when the second sign-up season for coverage under President Barack Obama's health care law gets underway next month.

Florida's candidates for Attorney General met for their first and only debate earlier this month in the studios of Bay News 9.

More than 35,000 Florida residents have lost the health insurance they enrolled in under the federal health law because they didn’t prove U.S. citizenship or legal residency status by Sept. 5, the Miami Herald reports. 

HealthCare.gov, the website for health insurance under President Barack Obama’s health care law, has been revamped as its second enrollment season approaches. But things are still complicated, since other major provisions of the Affordable Care Act are taking effect for the first time. A look at website and program changes just ahead:

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Old: 76 online screens to muddle through in insurance application.

Employer Plans: Premiums, Consumer Costs Hike

Oct 14, 2014

Fall is enrollment season for many people who get insurance through their workplace. Premium increases for 2015 plans are expected to be modest on average, but the shift toward higher out-of-pocket costs overall for consumers will continue as employers try to keep a lid on their costs and incorporate health law changes.

Experts anticipate that premiums will rise a modest 4 percent in 2015, on average, slightly higher than last year but lower than typical recent Increases.

“That’s really low,” says Tracy Watts, a senior partner at benefits consultant Mercer.

If former Florida Gov. Charlie Crist gets his old job back, he promises to expand Medicaid to roughly 1 million low-income residents by calling a special session of the Legislature or through an executive order. If Gov. Rick Scott is re-elected, the decision will be once again left to the Legislature with little meddling from him.

Streamlined Marketplace Site Unveiled

Oct 9, 2014
Healthcare.gov

Consumers using the federal healthcare.gov website when open enrollment begins next month should expect a faster website with a shorter application form and features making it easier to use on mobile devices, Obama administration officials said Wednesday.

In a briefing with reporters, they showed off a live version of the updated site and said it has already been used to enroll about 20,000 people.

Still, they did not promise that the website will be glitch-free when it opens for purchases on Nov. 15.

Lottie Watts / WUSF

Democratic candidates were the only ones to show at a legislative forum organized by the Tampa Bay Healthcare Collaborative. And each one said Florida needs to take federal funding to expand Medicaid under the Affordable Care Act.

The participants included Lorena Grizzle (D) – House District 66 candidate; Steve Sarnoff (D) – House District 67 candidate; Scott Orsini (D) - House District 69 candidate; and Judithanne McLauchlan (D) – Senate District 22 candidate.

Florida’s gubernatorial candidates say they support Medicaid expansion, but it’s hard to know that on the campaign trail, according to the News Service of Florida. Democrat Charlie Crist is pushing for a special session to consider expansion of the state health care program for the poor. Republican Gov. Rick Scott, who backed expansion in 2013, has remained fairly quiet on the issues.

Authorities have arrested three more suspects in a $55-million Medicare fraud scheme at a Miami Gardens clinic, the Miami Herald reports. 

Florida, Texas Expand Medicaid – For Kids

Sep 29, 2014

Republican lawmakers in Florida and Texas snubbed the Affordable Care Act’s Medicaid expansion for adults, but their states did broaden the program this year -- for school-age children.

The number of uninsured patients admitted to hospitals has dropped markedly this year, reducing charity care and bad debt cases, particularly in states that have expanded Medicaid coverage under the new federal health care law, a government report released Wednesday concluded.

The report from the Department of Health and Human Services said hospitals in states that have taken advantage of new Medicaid eligibility levels have seen uninsured admissions fall by about 30 percent. Florida is not one of those states.

The rate of Floridians without health insurance stayed the same in 2013 from the previous year, according to figures released Tuesday by the U.S. Census Bureau.

Twenty percent of Floridians lacked health insurance last year, down slightly from a rate of 20.1 percent in 2012. But the change was within the margin of error, rendering it insignificant.

Nationwide, the rate was 14.5 percent.

Potential complications await consumers as President Barack Obama's health care law approaches its second open enrollment season, just two months away.

Don't expect a repeat of last year's website meltdown, but the new sign-up period could expose underlying problems with the law itself that are less easily fixed than a computer system.

Getting those who signed up this year enrolled again for 2015 won't be as easy as it might seem. And the law's interaction between insurance and taxes looks like a sure-fire formula for confusion.

For example:

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.

commons.wikimedia.org

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.

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