Obamacare

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.

Demystifying Obamacare

Aug 13, 2013

It's the law of the land, and by Jan. 1, 2014, most Americans will be required to have some form of health insurance under the Affordable Care Act.

Yet, polls show many still are confused about the law and its implementation.

We spoke with Carol Gentry, founder and editor of Health News Florida, a subsidiary of WUSF Public Media in Tampa, for some basics about the ACA or Obamacare - and issues specific to Florida.

First Coast Connect: What should people know about the new insurance exchanges that will be online this fall?

Senate President Don Gaetz sent a letter in June to federal health officials asking for flexibility in designing a plan to cover the working poor under the Affordable Care Act that would not involve Medicaid.

There may be a way for 1 million below-poverty-level uninsured Floridians to gain access to health coverage, even though the state legislature voted against Medicaid expansion.

The Florida Center for Fiscal and Economic Policy has released an issue brief that says the Florida Office of Insurance Regulation is trying to mislead Floridians about the likely impact of the Affordable Care Act on insurance rates.

In a video posted by the Florida Times-Union, Florida Blue CEO Pat Geraghty explains why it  would be good for Florida business if state officials accepted federal dollars for Medicaid expansion. Geraghty also described how Florida Blue is planning to serve more customers once Obamacare comes to Florida by creating partnerships and becoming a health care company, not just an insurance provider.

PolitiFact

In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, Democratic members of Congress from Florida accuse the state of relinquishing power over health insurance rates to the federal government -- which lacks enforcement authority.

As fitness expert and personal trainer Marilynn Preston relaxed during a pedicure, she listened to the nail technician lament her confusion about the Affordable Care Act. In a column in the Sarasota Herald-Tribune, Peterson explains how she eased the woman’s fears with facts about the law. 

Associated Press

Members of the all-Republican Florida Cabinet -- Gov. Rick Scott, Attorney General Pam Bondi, Agriculture Commissioner Adam Putnam and Chief Financial Officer Jeff Atwater -- have approved disclosure forms that insurance companies will need to send out to policyholders if their premiums will be affected by the federal Affordable Care Act, the Times/Herald Tallahassee Bureau reports.

Lottie Watts / WUSF

We asked our readers to tell us what they thought was confusing about the Affordable Care Act, and you called, e-mailed and Facebooked us with questions. On Florida Matters, WUSF’s Craig Kopp sits down with attorney Linda Fleming of Carlton Fields; Julian Lago, the regional vice president of the National Association of Health Underwriters, and Health News Florida Editor Carol Gentry to help answer some of those questions. 

To listen to the complete show, visit the Florida Matters website

Chris Zuppa / Tampa Bay Times

With Congress on a five-week break, House Republicans left Washington bearing a playbook for themselves and talking points for business owners who may want to speak at public forums on the Affordable Care Act, the Tampa Bay Times reports.  Democrats say they’re prepared to go toe-to-toe defending the law. 

M. Spencer Green / AP

Florida Blue, the state’s largest insurer, has an inside track to a potentially lucrative market by entering a partnership with Spanish-language network Univision, Kaiser Health News and the Miami Herald report.

AP

Wayne Ezell, a member of the Florida Times-Union editorial board, writes that Sen. Marco Rubio is “maniacal” when talking about the Affordable Care Act.  Ezell cites PolitiFact’s “pants on fire” rating for Rubio’s inaccuracies.

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