News from Tallahassee for 9/1/14

Florida website aimed at the uninsured draws little interest posted on 8/29/14

by Tia Mitchell | Times/Herald Tallahassee Bureau

TALLAHASSEE — Last year, legislators allocated $900,000 to help Floridians find affordable health care through a new state-backed website.

At the same time, they refused to expand Medicaid or work with the federal government to offer subsidized insurance plans.

Six months after the launch of the state's effort, called Florida Health Choices (floridahealthchoices.net), just 30 people have signed up. Another seven plans were canceled either because consumers changed their minds or didn't pay for services.

These numbers are dwarfed by the nearly 764,000 Floridians who are too poor to afford subsidized plans, yet can't qualify for Medicaid under Florida's stringent standards. They are supposed to be the target market for Health Choices.

But Health Choices doesn't sell comprehensive health insurance to protect consumers from big-ticket costs such as hospitalization. Instead, it has limited benefit options and discount plans for items like dental visits, prescription drugs and eyeglasses.

The plan's biggest backer in the Legislature blames the lack of business on the federal Affordable Care Act, which features comprehensive plans with varying subsidies for those who qualify.

"Obviously we wanted more (business), but the competition is giving it away for free," said state Sen. Aaron Bean, R-Fernandina Beach.

Florida Health Choices administrators acknowledge they are off to a slow start. Their strategy is to seek new products and partners, and find out more about what consumers want. They're even open to selling insurance for pets if it lures customers.

"We're going to continue to grow and learn about our users and enhance the platform," said chief executive officer Rose Naff.

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ACA Exemptions Include Bill-Sharing posted on 8/27/14

by staff | Health News Florida

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. According to the Congressional Budget Office and the staff of the Joint Committee on Taxation, about 7 million Americans in bill-sharing groups are exempt from buying other insurance or paying a penalty. As an example of this type of arrangement, the Herald offers an example of a baby whose treatment at West Boca Medical Center in Palm Beach County totaled nearly $100,000 and was paid for by the Melbourne-based, not-for-profit Christian Care Ministry Medi-Share.

Obamacare Sign-Ups to Rise 23%? posted on 8/26/14

by Carol Gentry | Health News Florida

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.

The Office of Insurance Regulation is scheduled to present that and other information on the state's Affordable Care Act implementation Tuesday to the Florida Health Insurance Advisory Board. Made up mostly of industry representatives, it was created to advise state agencies.

The new OIR enrollment figure is lower by about 120,000 individuals than the one that the U.S. Department of Health & Human Services had reported on May 1. HHS noted at the time that the figure would likely drop a bit when companies were able to weed out duplicates and determine how many enrollees actually paid their premiums.

The new number is for individual enrollment in plans that comply with the 2010 Affordable Care Act. It doesn't count about 465,000 Floridians enrolled in old plans that don't meet the health law's standards; Floridians in those plans will be allowed to extend them another year.

Most individuals who enrolled in ACA-compliant plans this year used the federal Marketplace, OIR says, either through the Healthcare.gov website or a phone line. Just over 100,000 came into the program another way, through an insurer or an agent.

Previous reports from HHS noted that more than 90 percent of Floridians who enrolled in the federal Marketplace were able to get tax credits that reduced their premiums to an average of $68 a month.

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Scientology-related Narconon rehab center may have violated law posted on 8/26/14

by Joe Childs | Tampa Bay Times

When the Scientology-affiliated Narconon drug treatment center in Spring Hill was told by Hernando County it could not expand its residential facility, the center didn't try to make do with existing space.

Its officers rented three properties elsewhere in Spring Hill and expanded there. That allowed the center to admit more patients. Narconon charges up to $30,000 for a three-month stay.

One site was in a commercial center. Narconon shuttled patients there for what director Tammy Strickling described as "daily therapeutic classes.'' The other two sites were houses. One slept eight, the other six. Narconon staffers, trainees and overflow patients bunked there.

"I don't like turning anyone away,'' Strickling said in court last year.

But all three rented locations may have violated state law.

Substance abuse treatment centers in Florida are required to deliver services only at licensed facilities. Since Narconon opened in 2008, it had been licensed by the state Department of Children and Families to provide services at one place, 8213 Cessna Drive.

"My mouth is hanging open,'' said Department of Children and Families licensure specialist Troy McDermott, when told of the rented sites. In his 21 years at DCF, he never has encountered a center providing services at unlicensed facilities, he said.

Penalties can range from a moratorium on patient admissions to loss of license.

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Prescription painkiller deaths fall in medical marijuana states posted on 8/26/14

by Kathryn Doyle | Reuters

NEW YORK (Reuters Health) – Researchers aren't sure why, but in the 23 U.S. states where medical marijuana has been legalized, deaths from opioid overdoses have decreased by almost 25 percent, according to a new analysis.

"Most of the discussion on medical marijuana has been about its effect on individuals in terms of reducing pain or other symptoms," said lead author Dr. Marcus Bachhuber in an email to Reuters Health. "The unique contribution of our study is the finding that medical marijuana laws and policies may have a broader impact on public health."

California, Oregon and Washington first legalized medical marijuana before 1999, with 10 more following suit between then and 2010, the time period of the analysis. Another 10 states and Washington, D.C. adopted similar laws since 2010.

For the study, Bachhuber, of the Philadelphia Veterans Affairs Medical Center and the University of Pennsylvania, and his colleagues used state-level death certificate data for all 50 states between 1999 and 2010.

In states with a medical marijuana law, overdose deaths from opioids like morphine, oxycodone and heroin decreased by an average of 20 percent after one year, 25 percent by two years and up to 33 percent by years five and six compared to what would have been expected, according to results in JAMA Internal Medicine.

Meanwhile, opioid overdose deaths across the country increased dramatically, from 4,030 in 1999 to 16,651 in 2010, according to the Centers for Disease Control and Prevention (CDC). Three of every four of those deaths involved prescription pain medications.

Of those who die from prescription opioid overdoses, 60 percent have a legitimate prescription from a single doctor, the CDC also reports.

Medical marijuana, where legal, is most often approved for treating pain conditions, making it an option in addition to or instead of prescription painkillers, Bachhuber and his coauthors wrote.

» Read more

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