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. This week on Florida Matters, WUSF’s Craig Kopp sits down with attorney Linda Fleming of Carlton Fields, Julian Lago with the National Association of Health Underwriters and Health News Florida Editor Carol Gentry to help answer some of those questions.
The show airs tonight at 6:30 p.m. on WUSF 89.7 FM. You can listen to the live stream online by clicking on the “Listen Live” button in the top left corner of this page. A podcast of the half-hour show will be available on the Florida Matters website.
Here's an excerpt from the show:
CRAIG KOPP: Our next question comes from Carolyn Murray, who owns a franchise and has an individual policy.
CAROLYN MURRAY: I have health insurance right now but on my health care policy I have several exclusions of several body parts and I'm wondering if that type of exclusion on a health care policy will be allowed under the new health care act?
KOPP: Who wants to jump in on this one first? Julian Lago or Linda Fleming? I'm not sure I understand body part exclusion. Does the ACA keep what you have now or wipe things out?
LINDA FLEMING: Well, basically the big change, one of the big changes for next year in adult policies is they can't charge you more or exclude certain body parts. We call it pre-existing conditions and it's already gone away for children.
KOPP: All right, let's move on to a question that we got on the phone and this is from Matthew McDevitt. He called from Sarasota.
MATTHEW McDEVITT: I am with a company that offers health insurance. They had open enrollment in June and I decided to opt out. I'm still with the company. Can I just go back onto my company's health insurance at any time?
KOPP: Julian Lago with the National Association of Health Underwriters, what's the answer to that question?
JULIAN LAGO: Well, the open enrollment that's scheduled to take place for October is for the individual policies and basically for anyone who has opted off their employer plan, they're going to be best suited to make sure they take advantage of the individual open enrollment, so that they comply with the law effective Jan. 1. I would certainly encourage that individual to take advantage of the open enrollment through the individual policies to have qualifying coverage to bridge the gap until their employer's open enrollment occurs. At that time, they would not be subject to preexisting conditions or restrictions.
KOPP: Linda Fleming, attorney with Carlton Fields, how come we didn't get a big heads-up? Hey, if you've gotta enroll in your employer's insurance you better check it against the ACA requirements? I think people are kind of getting caught here a little bit.
FLEMING: Well most employers actually have their open enrollment period in the fall, so it shouldn't be that much of an issue, and also while employers can establish their own open enrollment periods, there are certain things that might happen in your life that would allow you to go ahead and enroll. Some of those things are you had a child, you get married, you get divorced.
KOPP: The Supreme Court upholds the Affordable Care Act? Does that count?
FLEMING: No. We've had a long time to get prepared for this. It's been a year now. So, I think the government is saying to us, even though they're saying it in a soft way at first, Craig, because while you're required to have health insurance, if you don't have it next year, the penalties aren't very steep.
More resources on understanding the Affordable Care Act:
- The federal government’s website HealthCare.gov
- Premium subsidy calculator
- Coverage from Health News Florida
