News from Tallahassee for 11/1/14

Another Court Rules Against ACA Subsidies posted on 10/2/14

by AP

Some of the health-insurance subsidies being offered under the Affordable Care Act in states including Florida represent an "abuse of discretion" by the federal government, a federal judge in Oklahoma ruled Tuesday, marking another volley in a years-long legal fight that could eventually reach the U.S. Supreme Court.

The ruling is the latest in a string of federal court decisions on regulations that allow health insurance tax credits in all 50 states. One of those cases has already been appealed to the high court.

In Oklahoma, U.S. District Judge Ronald White immediately put his ruling on hold pending an appeal.

But he sided with Oklahoma Attorney General Scott Pruitt, who argues that the law doesn't explicitly allow subsidies for people who buy insurance in Oklahoma, Florida and the other states that didn't set up their own insurance exchanges. The exchanges are online marketplaces where people can compare and buy health insurance.

Pruitt, who filed the lawsuit in 2012, said the IRS created a rule that allows it to levy millions of dollars in tax penalties on "large employers," which include state and local governments, in states using the federal exchange. That power, he argued, was never given to the IRS and allows the government to punish states that didn't create their own exchanges.

White agreed, ruling that the IRS rule was "an abuse of discretion" and represented "an invalid implementation" of the federal law.

The White House had no immediate comment on the ruling, while Pruitt called it "a consequential victory for the rule of law." The case is expected to be appealed to the 10th U.S. Circuit Court of Appeals.

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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.

» Read more

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