Understanding Obamacare

Once again the Supreme Court will decide whether the Affordable Care Act lives or dies.

Defying expectations, the court announced Friday it has agreed to hear a case that challenges the heart of the law: subsidies that help people pay their insurance premiums. In about three dozen states, the federal government runs the online marketplaces (exchanges) where individuals can find health plans.

Supreme Court Will Hear New ACA Challenge

Nov 7, 2014
U.S. Supreme Court

The U.S. Supreme Court agreed Friday to hear a new challenge to President Barack Obama's health care law that threatens subsidies that help millions of low- and middle-income people afford their health insurance premiums, including Floridians.

The justices said they will review a unanimous federal appeals court ruling that upheld Internal Revenue Service regulations that allow health-insurance tax credits under the Affordable Care Act for consumers in all 50 states. Opponents argue that most of the subsidies are illegal.

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.

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. 

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.

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.

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.

Wikimedia Commons

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.

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.

If you got health coverage through President Barack Obama's law this year, you'll need a new form from your insurance exchange before you can file your tax return next spring.

Some tax professionals are worried that federal and state insurance marketplaces won't be able to get those forms out in time, creating the risk of delayed tax refunds for millions of consumers.

The same federal agency that had trouble launching HealthCare.gov last fall is facing the heaviest lift.

States Help Pay ACA Tax On Insurers

Sep 2, 2014
Kaiser Health News

When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers.

But with an $8 billion tax on insurers due Sept. 30 -- the first time the new tax is being collected -- the industry is getting help from an unlikely source: taxpayers.

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.

Florida Senate President Don Gaetz is criticizing Democratic support for the Affordable Care Act, saying U.S. Sen. Bill Nelson in particular is ignoring the complexity of Obamacare.

Writing in the Palm Beach Post, Gaetz said Florida had bipartisan support when it opted to not formally approve health exchange insurance rates during the first two years of the ACA. 

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.

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