Cover Florida is ENDING

Cover Florida is ending.  Read this great article from South Florida Business Journal below.  I can't help but think this is what is to come with the Health Care Reform...

Cover Florida health plan program getting scrapped

Premium content from South Florida Business Journal - by Brian Bandell

Former Gov. Charlie Crist’s signature plan to help uninsured Floridians buy health insurance has gone belly up as insurers have abandoned Cover Florida.

With Blue Cross and Blue Shield of Florida’s decision to stop enrolling new members in its Cover Florida plan, all six insurers that were selected by the state to offer the plans starting in 2009 have withdrawn. Florida Agency for Health Care Administration spokeswoman Shelisha Coleman said the state has taken down the Cover Florida website, as no insurers want to participate.

It only took two years for Cover Florida to collapse.

Michael W. Garner, president and CEO of the Florida Association of Health Plans, said Cover Florida failed to attract enough relatively healthy enrollees to counteract all of the sick enrollees. That created a “death spiral” of higher claims and escalating premiums, he said.

“It does show you to really think through these type of issues before you put new plans into play, or you will have pretty substantial negative consequences,” Garner said.

With the federal government seeking to introduce new health plans for the uninsured as part of the Patient Protection and Affordable Care Act (PPACA), the demise of Cover Florida shows that launching new plans can be perilous.

Crist signed Cover Florida into law in 2008. He promised it would provide an affordable option for uninsured residents. The plan allowed insurers to offer stripped-down benefits with annual coverage limits, but the individual plans were guaranteed issue, meaning they had to accept people regardless of health conditions.

Report said plan was unlikely to work

In July 2008, before the program had even started, the Center on Budget and Policy Priorities issued a report saying that Cover Florida was unlikely to work as a remedy for the uninsured problem because the benefits were too skimpy to attract most enrollees.

Crist touted Cover Florida last year during his unsuccessful U.S. Senate campaign. Yet, the program had only 6,385 enrollees as of Dec. 31, according to ACHA data.

As of the most recent U.S. Census Bureau count, Florida had 4.1 million uninsured residents in 2009 – representing 26.6 percent of the population under age 65.

John Herbkersman, BCBSF’s senior director of external communication, said the insurer discontinued Cover Florida enrollment because it was concerned about the long-term financial viability of the program. It will honor its existing contracts with enrollees through January 2013.

As part of PPACA, the federal government has created a health plan for people with pre-existing conditions that could provide individual coverage to people who can’t pass medical underwriting, he noted.

Another part of the federal law would set up health insurance exchanges so people could pool together and buy coverage, including with federal subsidies for those with low-incomes. It would be guaranteed issue.

The downfall of Cover Florida shows that health insurance exchanges will not work unless they attract enough healthy enrollees, FAHP’s Garner said.

“The people who went into it didn’t have employer-sponsored coverage and couldn’t qualify for individual insurance because of their health conditions,” he said. “Yet, the problem was that younger uninsured people weren’t enticed to join Cover Florida and buy that policy.”

Cover Florida had more chronically ill patients than expected, especially older women with health problems, he said. By the end, the premiums for Cover Florida were no longer a good value.

Garner noted that the federal plans for a health insurance exchange sought to avoid this problem by making health coverage mandatory. But, a lawsuit by the state of Florida seeks to stop the insurance mandate and throw out the health reform law.

“I don’t know how you make it work if you have guaranteed issue,” Garner said. “Outside of mandating coverage, they haven’t solved how to do it.”

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Read more: Cover Florida health plan program getting scrapped | South Florida Business Journal

HealthCare Reform Breakdown CONT.

Continuation of Mike Vogel's article from FloridaTrend.com...

"NEW HEALTHCARE MANDATES

Kid CoverageBefore: No government mandate on how old an employee’s children can be before coverage expires.

Now: If a plan covers employees’ kids, coverage must be offered up to age 26.

Ounce of PreventionBefore: Employers and their insurers settled how much of preventive care — checkups and the like — was covered.

Now: Insurance has to cover 100% of certain preventive care.

Pre-ExistingBefore: People with pre-existing conditions could have treatment of that condition excluded from coverage under certain circumstances.

Now: No exclusions for pre-existing conditions up until age 19 and no exclusions over 19 starting in 2014.

Caps
Before: Companies could cap the maximum benefits they would pay. Typical plans capped employee coverage at $1 million to $5 million lifetime.

Now: Unlimited lifetime maximum for “essential” benefits.

The Bottom LineNew mandates raised rates 1.5% to 4% this year. “It’s obviously a factor,” says Steven Barber, an employee benefits lawyer and partner with Shutts & Bowen in Tampa, but “if nothing had happened, the costs would have gone up anyway.”

Indeed, the law-related increases came atop a 10% to 13% increase attributed to medical care cost rises. Employers responded with maneuvers such as raising deductibles and out-of-pocket maximums. That kept their cost increases to 6% to 9%. .."

HealthCare Reform Breakdown

Today I was reading up on the Health Care Reform just to see if anything new has come about since I last checked.  I didn't find anything new that I thought would benefit you substantially; however, I did come across this great article by Mike Vogel from FloridaTrend.com written a few months back that is extremely helpful.  He breaks down in very simple terms some of items that are being altered due to the Reform.  Over the next week or so I will be showcasing pieces of article to help you better understand the changes.

Here is the kickoff of Mike's fabulous article,

"Florida’s small-business owners are making like Scarlett O’Hara. When it comes to preparing for 2014 — when the bulk of the new healthcare law kicks in — they’ll think about it tomorrow.

The year 2014 is when the individual mandate and its penalties take hold along with insurance exchanges. For now, owners and managers are focusing on staying in business. Lacking the HR staff and time of larger companies, they feel they have enough to do absorbing this year’s health insurance rate increases. The sentiment is “we’ll worry about 2014 when it gets here,” says employee benefits adviser Steve Farmer, a senior vice president with Wallace Welch & Willingham in St. Petersburg. It’s not sloth; owners want to see what the courts and a Republican House and more balanced Senate do — and who is president in 2013..."

Repeal of the Afffordable Care Act

Photo by: AP Photo/Alex Brandon (Courtesy of The Palm Beach Post)

The Palm Beach Post had a great article in this morning's paper about Wednesday's vote casting by the U.S. House of Representatives to repeal the Affordable Care Act.  The vote was 245-189 that approved the "Repealing the Job Killing Health Care Law Act."  To read this article, just follow the link below:

http://tinyurl.com/4hecang