Quote:

 

http://kaiserhealthnews.org/news/florida-leads-nation-in-obamacare-enrollment-despite-gop-opposition/

Why Florida Is No. 1 In Obamacare Enrollment Despite GOP Opposition

When Florida workers promoting President Barack Obama’s health law marketplace want instant feedback, they go to an online “heat map.” The map turns darker green where they’ve seen the most people and shows bright red dots for areas where enrollment is high.

“The map shows us where the holes are” and what communities need to be targeted next, said Lynn Thorp, regional director of the Health Planning Council of Southwest Florida. She hands out information about the health law’s marketplace at rodeos, farmers markets, hockey games and almost any place where people gather.

That mapping strategy is one reason why a Republican-controlled state like Florida, whose leaders criticize the health law at every turn, is leading the nation in signing people up for private Obamacare health plans. With two weeks to go until the deadline for 2015 enrollment, Florida’s tally exceeds that of even Democrat-led California, which has embraced the law building its own online marketplace and has twice the population and uses three times as much federal funding for outreach.

“It’s surprising Florida has done as well compared to other states, and they will be looked at by folks who want to learn lessons to promote enrollment,” said Joel Ario, managing director for Manatt Health Solutions, a consulting firm, who worked for the administration setting up the exchanges soon after the law was passed.

As of mid-January, 1.27 million Floridians had enrolled in exchange plans, according to federal data, compared to 1.2 million Californians. Texas, which has 6 million more people than Florida, enrolled about 919,000 people in private plans. Both Florida and Texas have a 22 percent uninsured rate. California’s rate is 17 percent, according to latest Census data.

“It is truly ironic that Florida leads the nation in enrollment … with leadership that has actively opposed the law,” said Leah Barber-Heinz, executive director of Florida CHAIN, an advocacy group involved in outreach efforts. “It shows true commitment on the part of many and it portrays an extremely high need for affordable coverage.

There are other reasons cited for Florida’s robust enrollment —including intense competition among insurers in several big counties and the high degree of coordination among the nonprofits and community groups which received federal grants to sign people up.

Another key factor is the state’s decision not to expand Medicaid under the law. That’s left consumers with incomes above the federal poverty level of $11,600 per year with no coverage option other than to buy a private plan — with help from sliding-scale government subsidies. About 800,000 Floridians who make less than the federal poverty level are shut out altogether because they make too little to qualify for subsidies for private plans, but too much to qualify for Medicaid. In Florida, adults with children qualify for Medicaid only if their income is below 34 percent of the poverty level. Childless adults are ineligible. Florida is one of 22 states that chose not to expand Medicaid after the U.S. Supreme Court made that provision optional for states.

In contrast, California expanded Medicaid to those making up to 138 percent of the poverty level, or $16,100 for an individual. The program has grown by 2.3 million people since fall of 2013, boosted partly by publicity for the online marketplace.

Covered California spokesman James Scullary said the exchange is not allowed to enroll people in private plans if their incomes fall between 100 and 138 percent of the federal poverty line, because they qualify for Medicaid.

[...]

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http://www.nytimes.com/2015/02/03/us/politics/under-obama-budget-many-medicare-recipients-would-pay-more.html

Budget Plan Sees Savings in Changes to Medicare

In his new budget, President Obama proposed on Monday to squeeze $399 billion over the next 10 years out of Medicare, Medicaid and other programs run by the Department of Health and Human Services.....

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http://www.politico.com/story/2015/02/supreme-court-obamacare-case-poses-political-peril-for-gop-114849.html

Supreme Court Obamacare case poses political peril for GOP

The Supreme Court could be months away from blowing a huge hole in Obamacare — and Republicans on Capitol Hill are at odds over how they’ll respond if their side wins.

It’s the latest example in a long-running quandary for Republicans: They don’t agree on what alternative, if any, their party should offer to President Barack Obama’s signature health care law. But the issue is taking on new urgency for the GOP congressional leaders as the court takes up a case that could leave more than 5 million people without Obamacare’s crucial subsidies.

If they simply “fix” Obamacare, they‘ll anger their right wing that wants the party to focus solely on repealing the law. If they do nothing, they invite blame for making health care unaffordable for millions of Americans — including some of their own constituents.

[...]

kbp

Feb 4 2015, 07:31 AM

http://www.wsj.com/articles/gop-lawmakers-weigh-contentious-tactic-to-dismantle-health-law-1422638911
GOP Lawmakers Weigh Contentious Tactic to Dismantle Health Law


How many years have they been weighing the options??????

Quote:

 

http://kaiserhealthnews.org/news/medical-debt-still-a-problem-under-health-law-despite-protections/

Medical Debt Still a Problem Under Health Law — Despite Protections

[...]

The federal health law was intended to keep a surprise illness or injury from bankrupting Americans. It authorized states to expand eligibility for Medicaid and created online insurance markets where others without employer coverage can buy plans, with federal subsidies available. When calling for the law’s passage, President Barack Obama declared people shouldn’t “go broke because they get sick.”

In 2013, medical debt was the largest cause of personal bankruptcy – 1.7 million people lived in households experiencing bankruptcy because of health costs. But the law hasn’t eliminated the problem. Many states haven’t expanded Medicaid and even those with insurance can rack up big bills, a problem exacerbated by the growing number of plans with high deductibles.

The health law brought regulations to limit for the first time the cost-sharing in plans. An individual plan sold on an exchange can’t include out-of-pocket costs greater than $6,600. In practice, the average deductible, or portion a consumer must pay before insurance kicks in, varies based on how expensive a plan is. But the regulation still only applies to providers and specialists specified by the plan as “in-network.” The narrower the network, the more vulnerable consumers are to incurring medical debt by visiting unapproved doctors or hospitals.

The health law wasn’t supposed to eliminate health care cost-sharing; on the contrary, people are expected to have “skin in the game.” So there will always be a risk of incurring costs greater than people can afford to pay, said Melissa Jacoby, a professor at the University of North Carolina-Chapel Hill and an expert on debt and credit.

“Some of the forces that were in play prior to the passage of the Affordable Care Act are still in play,” said Mark Rukavina, who founded Community Health Advisors, a group that advises providers on how to comply with federal regulations. Inflation and rising health care costs – especially compared to wages – make care more expensive and weren’t necessarily addressed through the health law.

Still, some numbers suggest a decline in people facing medical debt. About 64 million Americans struggled to pay medical bills in 2014, according to a survey by the Commonwealth Fund – that’s a drop of about 10 million since 2012. Experts have celebrated the decline but cautioned that high-deductible insurance plans could put a damper on those changes.

[...]

Deductibles keep growing. Last year, work-sponsored insurance plans had an average deductible of about $1,200 – in 2009, the average deductible was $826. And this year, the silver plans sold through the federal marketplace require people to pay on average more than $2,500 or about $3,500 before they get coverage. Whether it is the higher or lower amount is determined by whether the plan groups medical visits and drug costs in a single deductible or two separate deductibles. Bronze plans, known for being cheaper but less generous, have average deductibles of about $5,300.

[...]

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Ultimately, what may be needed to address the obesity problem are direct taxes on body weight. While it is hard to conceive of this approach being a common public policy tool in the near term, such taxation may be happening indirectly through health insurance surcharges.

LTC8K6

Feb 4 2015, 09:47 PM

Jonathan Gruber: The Gift That Keeps on Giving

http://www.powerlineblog.com/archives/2015/02/jonathan-gruber-the-gift-that-keeps-on-giving.php

Quote:

 

Ultimately, what may be needed to address the obesity problem are direct taxes on body weight. While it is hard to conceive of this approach being a common public policy tool in the near term, such taxation may be happening indirectly through health insurance surcharges.

Quote:

 

http://www.usatoday.com/story/news/nation/2015/02/04/healthcaregov-enrollment-deadline-problems-solutions/22860185/

ACA sign-ups estimated near 10 million as deadline looms

The federal health insurance marketplace will have 40% more call center workers on hand starting Monday to help consumers deal with the final week of Obamacare open enrollment, the Department of Health and Human Services said Wednesday.

Since open enrollment began on Nov.15, nearly 7.5 million consumers selected a plan or were automatically re-enrolled on HealthCare.gov, which is handling enrollment for 37 states, HHS said. When all states are combined, HHS Secretary Sylvia Burwell estimated about 9.9 million people enrolled or were automatically re-enrolled. The rate of sign-ups is expected to accelerate until the Feb. 15 deadline.

Andy Slavitt, principal deputy administrator of the Centers for Medicare and Medicaid Services, urged people "not to wait until the last minute" to sign up. For those who do, however, there will be 14,000 call center employees available, up from 10,000 now.

If people are waiting in an online queue for an overloaded website or on hold for the call center at midnight on Feb. 15, Slavitt says, "we'll make sure they get covered."

If not, they will have to wait another year for coverage and will be subject to a penalty on their taxes.
[Until Barry changes that with his 'pen and phone.']

[...]

The product is better than ever, though, HHS says. In what has become the federal mantra, HealthCare.gov is offering "better prices, more affordability and more options," said Kevin Counihan, HealthCare.gov's CEO.
Hmmm... (insert thud!) Obamacare drove the prices went up. There are fewer choices than pre-Obamacare. The "affordability" comes thru money from others paying for it.]

Besides, Counihan says, "we want people to get the security of health insurance."

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http://www.latimes.com/nation/la-na-gop-health-plan-20150205-story.html

Republicans outline their Obamacare alternative

[...]

The plan, titled the Patient Choice, Affordability, Responsibility and Empowerment Act, sets out ambitious goals.

It would guarantee coverage to Americans with preexisting medical conditions, though the assurance is more limited than what the current law offers because it protects only consumers who maintain continuous health coverage.

Like the current law, the Republican proposal would also offer subsidies to low-income Americans to help them buy health plans, a system that the plan's architects say should ensure their program helps expand coverage, a central accomplishment of the Affordable Care Act.

In a move to control insurance premiums, the Republican blueprint would scrap most requirements on health plans in the current law, including mandates on what benefits they must offer and a prohibition on annual limits on coverage. (The plan maintains the current ban on lifetime limits on coverage.)

And the Republican outline would dramatically restructure the way the federal government funds state Medicaid programs for the poor, moving to a system of block grants that restrict federal expenditures and place fewer requirements on states.

"We can lower costs and expand access to quality coverage and care by empowering individuals and their families to make their own healthcare decisions, rather than having the federal government make those decisions for them," Burr said.

At the same time, the plan would ditch several of the most unpopular features of the current law, including the requirement that Americans get coverage and a host of new taxes.

According to congressional aides, the Republican plan maintains hundreds of billions of dollars in Medicare cuts in the current law, which would be key to offsetting the cost of extending new subsidies to consumers.

[Politicians on the right stealing using the imaginary "savings" from the left!]

The only major funding source in the plan is a new tax on employees who have high-priced employer-provided health plans worth more than $12,000 for individuals or $30,000 for families.

[...]

Quote:

 

http://www.nytimes.com/aponline/2015/02/05/us/politics/ap-us-republicans-health-care.html

GOP Lawmakers: Scrap Obama Health Law, Use Tax Credits

Three Republican lawmakers eager to repeal President Barack Obama's health care overhaul are touting tax credits and greater leeway for states and health insurers as the GOP unveiled its first plan this year for replacing the law that the party reviles.

Republicans released the outline Wednesday as Democrats continue pounding away at them for pledging to repeal and replace Obama's law, practically since its 2010 enactment, without advancing a substitute. That's a growing political liability for Republicans because the nonpartisan Congressional Budget Office estimates that this year, 19 million Americans will receive coverage as a result of the law, including large numbers in GOP-dominated states.
[Sorry NYT, Burwell revised that goal again and again, so those numbers ...never mind!]

"We need to be prepared to talk about something we could support," said House Energy and Commerce Committee Chairman Fred Upton, R-Mich., one of the proposal's authors.

Senate Finance Committee Chairman Orrin Hatch, R-Utah, and Sen. Richard Burr, R-N.C., a Finance panel member, also wrote the proposal.

The plan — it's not in legislative language and may not be anytime soon — erases the existing law's coverage requirements for individuals and employers. It eliminates the state and HealthCare.gov federal insurance marketplaces where insurance can be purchased and ends virtually everything established by the health care law, including taxes it imposes on medical devices and other things to finance enlarged coverage.

[...]

Quote:

 

http://www.cnsnews.com/news/article/susan-jones/hhs-secretary-not-focused-possibility-court-will-nix-obamacare-subsidies

HHS Secretary Not Focused on Possibility That Court Will Nix Obamacare Subsidies

Health and Human Services Secretary Sylvia Mathews Burwell told Congress on Wednesday she is focused on signing people up for Obamacare -- not on planning for the possibility that millions of Americans may end up losing the tax-credit subsidies that help them afford insurance in the first place.

She also announced that in the current open enrollment period, 7.5 million people already have signed up through the federal exchanges and 2.4 million have signed up on the state-run exchanges. "And large majorities of those people are receiving the financial assistance (tax-credit subsidies) that is being provided," she said.

But what happens if many of those subsidies go away? Burwell wouldn't say.

The Supreme Court will soon decide whether the Internal Revenue Service acted legally when it extended tax credit subsidies to people who buy their insurance on the federal exchanges. The Affordable Care Act specifically says that subsidies apply only to insurance that is purchased through an "Exchange established by the State." And most states did not set up their own exchanges.

"Secretary Burwell, does the administration have a contingency plan in case the court invalidates premium tax credits for people buying insurance on the federal exchanges?" Sen. Orrin Hatch (R-Utah) asked Burwell at Wednesday's hearing of the Senate Finance Committee:

"Senator, right now, what we believe is that the position that we hold...is the correct position," Burwell responded. "The idea that tax credits would be provided by the Congress for individuals in, say, the state of New York (which has a state-run exchange) but not the state of New Jersey (which uses the federal exchange) is something that we don't believe the Congress intended in any way. And we believe the letter of the law supports that."

But it appears that Congress did intend that, Hatch replied. (According to Obamacare architect Jonathan Gruber, Congress wanted to prod the states to form their own exchanges, so it used tax-credit subsidies as an inducement for them to do that.)

"So that's a big issue," Hatch said.

The senator then repeated his question to Burwell: What happens if the Supreme Court does find that only state-run exchanges can offer subsidies?

"Right now, Mr. Chairman, what I am focused on, and I think everyone here knows that Feb. 15 is the end of the (open) enrollment. And in terms of providing quality affordable access to healthcare, my deep focus right now is...to focus on completing and implementing the law -- which we beleive the is the law -- that's where my focus--"

"So no, you don't have a contingency plan, that's all I'm asking," Hatch interrupted. "I would suggest that the administration get one, just in case. It's something that, it seems to me, you're going to have to have because there's a possibility that millions of people will need coverage when this law runs out."

Hatch asked Burwell if she's talked to insurers about the possibility that the subsidies offered on the federal exchange will become illegal.

"What we continue to do is work with the insurance providers to implement Affordable Care Act -- we are working very closely with them as part of this open enrollment..." Burwell said.

Hatch said he's more concerned about contingency plans, but Burwell stuck to her script: "Senator, right now we are focused deeply on those issues that I've articulated."

Hatch said as far as he knows, insurers haven't been given any guidance about what to do if the Supreme Court invalidates the subsidies paid to them, "so it's somethig I would hope that you'd get on top of, just as a contingency plan, to make sure that you can handle these matters."

• 
  
• ...Hatch asked Burwell if she's talked to insurers about the possibility that the subsidies offered on the federal exchange will become illegal.
  
  "What we continue to do is work with the insurance providers to implement Affordable Care Act -- we are working very closely with them as part of this open enrollment..." Burwell said.