Obamacare

(Updated) Saying "Florida has done some pretty unbelievable things," top federal health official Kathleen Sebelius told Jacksonville leaders on Monday she hopes they will get the word out that help for the uninsured is on the way.

Tampa Tribune

Bob Linde, who runs a business in St. Petersburg, has been unable to get health insurance for a decade because of Gulf War Syndrome symptoms that dot his medical records. When it was available, it was unaffordable.

But he worries that a serious illness or injury could wipe him out. Come Jan. 1, that worry will go away for Linde and others who have been unable to obtain affordable and decent health coverage.

People who lose their jobs and the health insurance tied to them will have new coverage options when the Affordable Care Act's marketplaces open in October.

But consumer advocates are concerned many of these unemployed people may not realize this and lock themselves into pricier coverage than they need.

One company that was going to help enroll uninsured Floridians in health insurance through the federal online Marketplace has dropped out in the face of state officials’ continuing hostility to everything about the Affordable Care Act.

As Chan Lowe with the South Florida Sun-Sentinel writes, it’s just a matter of time before the fight against the Affordable Care Act will die. As Lowe writes, it happened with Social Security and Medicare, once folks started to benefit from those programs. Lowe predicts that same thing will happen with the federal health law better known as Obamacare.

Chris Urso, Tampa Tribune

Anita Balch is a nurse, so everyone asks her about the Marketplace and other key features of the Affordable Care Act that are coming on line between now and Jan. 1. But she’s just as confused as everyone else, she says, because of the five-year political fight that Republicans have waged against Obamacare.

With the launch of new health insurance exchanges just about two weeks away, many of the questions in this month's mailbag focused less on the big picture and more on exactly how the law will operate for individuals.

We can't answer every question we get. But here is a sampling of questions that were really popular, or that would apply to a lot of people.

Florida's uninsured citizens, who are relying on the federal government to create and manage an online health-insurance shopping site called the "Marketplace," can relax a little, after months of hearing that the project won't be ready in time for the grand opening Oct. 1.

Florida’s uninsured citizens -- at least the ones who have heard about the health-insurance “Marketplace” scheduled to open Oct. 1 -- aren’t the only ones eager to see how it works. The same is true of insurers in the individual market who have to participate, despite their worries, for fear they will lose market share if they don’t.

Wikipedia.com

Michigan, which like Florida has a Republican governor and legislative majority, has voted to accept federal funds and expand its Medicaid program to the low-income uninsured. It is yet another GOP-dominated state that has done what Florida did not.

More than 1 million low-income uninsured in Florida are spared from paying any penalty for not having health coverage under the Affordable Care Act as of Jan. 1, according to the rules issued this week by the Obama administration.

Florida is facing a challenge: With the start of the health-insurance enrollment period less than five weeks away, paid “navigators” and volunteers are still unsure how they will find and sign up millions who qualify for and need coverage. State officials have not helped, the South Florida Sun-Sentinel reports. 

Some of the large employers in Florida’s tourism and retail industries could get away with providing very cheap coverage -- so “skinny” it doesn’t even cover a hospital stay -- under one interpretation of the administration’s rules on the Affordable Care Act Rules, Kaiser Health News reports.

Given all the political fighting over the Affordable Care Act's online Marketplaces, many Americans likely think everyone will be shopping on them. In reality, most Americans won't be. The marketplaces are only for individuals who can't get (or can't afford) coverage through their employer. Small businesses will have their own Marketplace for shopping.

Medicare beneficiaries won't be on the new Marketplace. They have a separate system for enrolling in Medicare Advantage and prescription drug plans -- the same system they've been using for years.

Lottie Watts / WUSF

When the new online health insurance marketplace opens Oct. 1, millions of people will be able to buy insurance at the click of a mouse. The federal government has a website and a hotline people can call for help. But they'll also have people who can help face-to-face. They're called "navigators."

During a stop at the USF Tampa campus last week, U.S. Health and Human Services Secretary Kathleen Sebelius said "navigators" will assist many people who have never been enrolled in a health plan before. 


Health policy and political consultants say that for the Affordable Care Act to succeed, politically and substantively, organizing efforts must focus on three states with large numbers of uninsured: Florida, Texas and California. Unfortunately for Democrats and the law’s supporters, as Politico reports, two of those states are run by Republicans who are trying to hamper the enrollment effort.

Opponents of the Affordable Care Act rallied hundreds of conservatives at a Tampa hotel Wednesday night with a call for the Republican House to strip funds for the law out of next year's budget.

The budget vote is scheduled for right after Labor Day, in time for the 2014 fiscal year, which begins Oct. 1.

"Can we defund Obamacare? Yes, we can!" declared Mike Needham, CEO of the host group Heritage Action for America. The crowd applauded heartily at his use of President Barack Obama's campaign slogan.

Supporters of the Affordable Care Act say Florida officials' concern about a program that will help uninsured people sign up for coverage has no foundation in fact.

There is no danger that so-called "navigators" will steal people's identities or feed information into a giant federal database, said Greg Mellowe, policy director for the consumer group Florida CHAIN. The group is one of the non-profits that will get a share of federal grant money for the "navigator" program.

U.S. Sen. Marco Rubio, whose mother is enrolled in a Medicare Advantage plan that drives her to doctors’ appointments, claims that such plans will be hurt by the Affordable Care Act. PolitiFact  checked out that claim.

State Cabinet officials expressed concern Tuesday that the federal government's "navigator" plan would place Floridians' personal information in danger. They urged citizens to use state-licensed insurance agents to get help deciding which is the best insurance plan when the federal online Marketplace opens Oct. 1.

Gov. Rick Scott said he fears that the federal government wants to amass a huge database of personal information on citizens' health.  He said he's worried that the navigators will turn over information for that database.

The House and Senate sponsors of the law that removed Florida insurance officials' ability to regulate health-insurance rates for two years said they stand by their decision, which has come under increasing criticism by consumer groups and newspaper editorial boards. 

One rule of the Affordable Care Act that has been delayed for a year limits the amount that a patient has to spend on so-called "out-of-pocket" costs -- mainly deductibles and co-payments.

But it hasn't been delayed for everyone. Those who buy their own coverage are still protected; the delay affects some employer plans.

The Obama administration agreed to delay the rule for employer plans that use different vendors for their medical and drug coverage, after some companies said they couldn't get their vendors' computer programs to work together without more time.

In his Saturday address, President Obama complained that critics of the Affordable Care Act are trying to "gum up the works" to keep the health law from succeeding as implementation of its major features nears on Jan. 1, as Politico reports.

The Oct. 1 launch of the new health insurance exchanges is now less than two months away, and people are starting to pay attention to the changes these new marketplaces may bring to the nation's health care system.

Miami.com

It appears that virtually all counties in the state will receive "navigators" to help their uninsured residents learn how to get coverage under the Affordable Care Act except the one county that needs help most: Miami-Dade.

With more than 30 percent of its under-65 population lacking health insurance, Miami-Dade is not among the counties listed as a specific target by organizations who received Navigator Grants. On Thursday,  Kathleen Sebelius, secretary of the Department of Health and Human Services, announced $7.8 million in grants for Florida.

Scott Keeler / Tampa Bay Times

With Congress on a five-week recess, members are rallying the troops around the state. And the troops are responding. As the South Florida Sun-Sentinel reports, U.S. Rep. Debbie Wasserman Schultz introduced Leslie Sheffield of Fort Lauderdale, a cancer survivor who cares for her 92-year-old mother. Sheffield told a crowd that she and her husband both got sizeable rebate checks on their health insurance this year because of the health law. Wasserman Schultz is a Democrat from Weston. 

Health and Human Services Secretary Kathleen Sebelius was on the University of South Florida Tampa campus Thursday afternoon to hand out $7.8 million in grants to help Floridians with the Affordable Care Act. 

The money will be given to eight organizations around the state to hire staff to help consumers enroll in a health insurance plan. Starting Jan. 1, almost all Americans will be required to buy health insurance under the ACA.

Florida Insurance Commissioner Kevin McCarty says there's no need for the state to regulate health premiums because the Affordable Care Act has a rule that keeps them under control. 

In a discussion with the Orlando Sentinel editorial board, McCarty said the ACA contains a "self-regulator" that limits the amount of the premium that companies can keep for administrative expenses and profits. If insurers spend too little of the premium on health care, he said, they have to return it to the customers who overpaid -- individuals and employers.

Health policy consultant Paul Gionfriddo of Lake Worth writes this week in his blog Our Health Policy Matters a new chapter on an earlier subject:  Why the Affordable Care Act will not be repealed by 2016 no matter how many votes the House takes on it, and despite threats to shut down the government.


It turns out that a good many constituencies will have much to lose and will figure that out quickly, he says.

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