News from Tallahassee for 10/25/14

Florida, Texas Expand Medicaid – For Kids posted on 9/29/14


Republican lawmakers in Florida and Texas snubbed the Affordable Care Act’s Medicaid expansion for adults, but their states did broaden the program this year -- for school-age children.

Those states were among 21 – including some big Democratic-led states, such as California -- that were required to widen Medicaid eligibility for children between the ages of 6 and 18 by 2014. That little-known provision of the health law is a key reason hundreds of thousands of kids gained coverage in the state-federal health insurance program for the poor, according to a Kaiser Health News survey of a dozen states.

While many of those kids were previously enrolled in another government insurance program, children are typically better off in Medicaid because it offers broader health benefits at lower cost to their families. The higher eligibility level was already in effect for children younger than 6.

California led the way, increasing Medicaid enrollment by 715,000 children age 6 to 18. Five other states — Texas, New York, Florida, Georgia and Colorado — accounted for about 750,000 additional enrollees, according to data measuring growth through this summer.

In Florida, enrollment of school-age children in Medicaid rose by 137,000 this year, which included more than 62,000 kids who transferred from the state’s CHIP program, according to Florida Healthy Kids Corp., the nonprofit that runs CHIP in the state. That switch saved families money, since they previously had to pay a $15- or $20-a-month premium for CHIP coverage.

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FL Marketplace Adds 4 Insurers posted on 9/24/14


The number of health insurance companies offering plans in the marketplaces this fall will increase by 25 percent, giving consumers more choices for coverage, Health and Human Services Secretary Sylvia Burwell announced Tuesday.

When the marketplace enrollment reopens in November, 77 new insurers will be offering coverage in the 44 states for which HHS had data, which includes the 36 states that use the federal marketplace and eight states that run their own, the department reported.

In Florida, there will be four new issuers selling plans on, according to federal health officials. That brings the number of companies that will sell plans on the marketplace in Florida to 14.

Florida's Office of Insurance Regulation had released that information six weeks ago in the context of predicting a rise in premiums -- a claim that federal officials contradicted the following day. Here is a link to the list of ACA-compliant plans in Florida for 2015.

Health News Florida analyzed the conflicting claims and concluded that price-conscious shoppers can find 2015 plans similar to those they obtained in 2014 at the same or lower cost in nearly all areas of Florida. The key is taking the time to study changes, not just keeping the previous plan without checking.

Last year, 10 insurers filed documents to sell plans to Floridians on the marketplace.

The number of competitors on the marketplaces is considered important because it signifies the vitality of the exchange and can mean increased competition and lower prices for consumers. It also means that insurers see the health law’s online marketplaces or exchanges, as a good business opportunity, senior HHS officials said.

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The Secret Prices Of Health Care: How What You Don’t Know Can Cost You posted on 9/17/14

by sammy mack | Health News Florida

When Uwe Reinhardt tries to explains the Gordian Knot of hospital pricing to his health care economics students at Princeton University, he has a go-to metaphor:

“It's almost like blindfolding people, shoving them into Macy's and saying, ‘buy — efficiently — for a shirt.’ Well you come out with a pair of shorts,” says Reinhardt.

As WLRN and the Miami Herald have been documenting all this week, the tangle of employers, insurance companies and providers makes shopping for health care and health insurance difficult enough — but underneath that web is a layer of secrecy that prevents consumers from seeing what actually gets paid for care.

And according to Reinhardt and others, what you don’t know can cost you.

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35K in FL Risk Losing Health Law Tax Credits posted on 9/17/14

by AP

Thousands of consumers risk losing financial aid for health care premiums under President Barack Obama's law unless they clear up lingering questions about their incomes, administration officials said Monday.

The Health and Human Services Department said some people who got coverage have reported incomes that don't square with what the government has on record. At least 279,000 households with income discrepancies face a Sept. 30 deadline to submit documentation. If not, their premiums will be adjusted up or down in November.

Florida and Texas top the list of citizenship- and immigration-related cancellations, with 35,100 and 19,600, respectively. But the administration did not report any information for immigration mega-states like California and New York, which are running their own insurance marketplaces. That omission means total cancellations could be significantly higher.

Those consumers would still have a policy, but many risk seeing their financial subsidies slashed. Some may no longer be eligible for any help with their premiums. It's also conceivable that some could actually be entitled to a bigger tax credit that would lower what they pay. Andy Slavitt, a senior official overseeing the website, said the government has no way of knowing at this point.

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FL 'Navigator' Grants Total $6.8M posted on 9/9/14

by Carol Gentry | Health News Florida

The University of South Florida has been awarded by far the largest grant in the state to hire "navigators" who help uninsured people sign up for health insurance coverage through the federal Marketplace, the Department of Health and Human Services announced Monday.

Only two other Florida organizations won navigator grants: the Epilepsy Foundation of Florida, $871,275, and the Pinellas County Commission, $535,156.

This year's USF grant, of almost $5.4 million, is even larger than the $4.2 million USF received last year. The territory covered is greater this year; USF has responsibility for all 67 counties, while for 2014 others did enrollment for Broward, Miami-Dade and Monroe counties.

HHS did not say why USF was chosen, but the outcome last year won widespread praise. Florida signed up more people for coverage through than any other state participating in the federal Marketplace. The number who enrolled in plans was well above 900,000, but recently the Office of Insurance Regulation reported that 866,485 Floridians actually paid for premiums.

USF's Covering Kids & Families Program, in the College of Public Health, coordinates the enrollment through 12 organizations around the state, most of them grass-roots non-profits. It's important to have local people leading the effort, said Jodi Ray, program director.

"We're able to provide 1- on-1 assistance to many thousands of consumers and get them through the process, so I think the strategies we have and the fact that we have a very strong infrastructure in terms of a network in place has been effective," Ray said.

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