MIAMI (AP) — Reaching the uninsured may prove more difficult the second time around as the second enrollment season under the Affordable Care Act kicks off Saturday.
Florida Health officials are feeling the pressure to re-enroll nearly 1 million Floridians plus recruit new enrollees who sat out the first year — all in half the time. The three-month enrollment period begins Nov. 15.
Despite strong opposition from the Republican-led Legislature, Florida was the unexpected star last year, getting more enrollees than any other state using the federal marketplace instead of its own program.
“We’re going to have our hands full,” said Jodi Ray, who oversees the University of South Florida’s “navigator” program, which has more than 150 health counselors assisting consumers from Key West to Pensacola. The program is expanding its outreach to healthy, young adults and getting increased support from local hospitals to target uninsured Floridians.
The bugs have supposedly been removed from the famously troubled http://www.healthcare.gov website, which can withstand last season’s peak loads and beyond with at least 125,000 simultaneous users. The online application has been pared from 76 screens to 16 for most consumers
The law’s supporters also have additional ammunition this year to encourage enrollment. Fines for staying uninsured the full year jumped to $325 from $95.
“Folks coming in this year will be younger folks because they sat out last year,” and they’ll likely purchase plans with low-cost premiums, said Jon Urbanek, a senior vice president with Blue Cross and Blue Shield of Florida.
The “young invincible” crowd of 18-to-36 year olds is crucial to the law’s success because insurance companies need their business to offset the costs of covering older, sicker and more expensive enrollees.
It’s unclear how much the new plans will cost.
Federal health officials have said the majority of Floridians will see their out-of-pocket costs decrease, especially in big cities like Miami, with double digits drops predicted in Orlando and West Palm Beach. But state insurance officials have said consumers could expect an average premium increase of 13 percent.
Experts say education is one of the biggest challenges as many consumers only focused on the low monthly premium last year and didn’t understand the potentially high deductible and out-of-pocket costs. Consumers were confused when they discovered their doctor wasn’t in their plan’s network or that they had to pay for testing because deductibles hadn’t been met.
More than 400 complaints were filed with state officials about the so-called Obamacare insurance. After networking complaints, the top concerns were consumers who said they’d paid for coverage but hadn’t gotten an ID card or couldn’t get prescriptions because the pharmacy had no record of insurance, according to an analysis by The Associated Press.
Consumers and health counselors waited hours on the phone last year trying to pay their first month’s premiums as backlogged insurance companies struggled to meet demand.
Insurance companies say volume will always be an issue because open enrollment coincides with Medicare enrollment and many large groups also renew their policies in January. But insurers say they’ve expanded internet bandwidth, added staff and increased customer service hours.
It’s too soon to determine whether consumers are getting free prevention tests and establishing a relationship with primary care providers to avoid costly emergency room visits. Anecdotally, consumers seem to be getting services, said Leah Barber-Heinz, CEO of health advocacy group Florida Chain.
Betsy Williams, a 62-year-old freelance photographer from Port Charlotte, is paying $305 a month for a Florida Blue plan. It’s about $100 more than she was paying under her old plan, but Williams is thrilled because she was able to add her 22-year-old daughter.
“It’s a much better policy than what I had,” said Williams. Prescriptions that would have cost $38 under the old plan now cost just $5 and she recently used the plan for the first time after having chest pains. “They did all kinds of tests and stuff and so far they’ve paid everything.”
(© Copyright 2014 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)
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