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Key Obamacare questions remain unanswered

Sept. 13 (Orlando Sentinel) With fewer than three weeks until the kickoff of the new Obamacare health-insurance exchange, Florida's 3.8 million uninsured residents still don't have answers to key questions, such as how much will the plans cost, what they will cover and how to sign up.

Gov. Rick Scott and the Florida Legislature opted not to participate directly in Obamacare, making Florida one of 26 states that have left it to the federal government to set up the online "exchange" that will enable individuals and families to purchase subsidized coverage.

Obamacare requires that most uninsured people purchase coverage -- either through their jobs, an agent or the exchange -- by Jan. 1 or pay a tax. That means Floridians will have to pick, apply for and receive a policy by Dec. 15 in order to be enrolled by the Jan. 1 deadline.

The exchange goes live -- meaning that's when people can sign up -- on Oct. 1, and there might be no details until then.

"We probably won't be able to see this information before Oct. 1," predicted Jennifer Tolbert, director of state health reform at the Henry J. Kaiser Family Foundation, which has been closely following developments in Florida and elsewhere. "In some states the rates and plans and information have been available earlier. But for most of the states in the federal marketplace, it's looking like Oct. 1."

So what's causing the delay?

The federal government didn't hand out until last month $8.2 million in grant money supposed to pay for "navigators" who will both help people sign up for coverage and spearhead volunteer efforts. And the state's Office of Insurance Regulation, which must sign off on policies to be issued through the exchange, now says only it will meet the Oct. 1 deadline.

"It might be sooner," said Amy Bogner, spokeswoman for the Florida Office of Insurance Regulation.

Federal officials say there will be plenty of time before people must be signed up, and help will exist for people to find out how to sign up. Besides the federally funded "navigators," numerous volunteer groups have begun door-to-door efforts to identify uninsured people.

OIR did release a handful of estimated rates weeks ago, but the state has not put together any detailed table showing who might pay what.

Copies of insurance companies' proposals are posted on the OIR website, but the proposals run hundreds of pages each, and there is nothing to explain them to consumers.

Figuring out who will pay what is complicated by the fact that Florida may have different rates for each of the state's 67 counties, and companies can apply to sell as many as four levels of policies, dubbed bronze, silver, gold and platinum based on their array of benefits.

And It is unclear whether the federal government has even decided which health-insurance companies will be approved. Today was to be the deadline for those decisions, but federal officials said Thursday that they were extending that at companies' requests.

Rates and subsidy calculations have been released by a handful of other states, and a Kaiser study shows that some people who qualify for subsidies may find basic coverage available for less than $100 a month in some places, and that those who do not qualify for subsidies might see monthly premiums as high as $400 for moderate coverage.

Federal subsidies -- paid directly to insurance companies on behalf of eligible individuals and families -- can be available on a sliding scale for individuals making as much as $45,960 and for a family of four making as much as $94,200.

Federal officials say help will be available through libraries; CVS pharmacies; nonprofit groups including the Central Florida Family Health Center in Sanford and Health Care Center for the Homeless in Orlando, some state health centers, including one in Kissimmee, that have received federal grants; and insurance brokers, agents and companies.

U.S. Health and Human Services Secretary Kathleen Sebelius and CVS Caremark President Larry Merlo will be at a CVS store in Orlando on Friday to announce how the pharmacies will help.

Blue Cross & Blue Shield of Florida, which has bid to offer Obamacare policies in all 67 Florida counties, has nearly doubled its staff in its 11 regional retail offices and plans to open five or six more offices to handle walk-in traffic. It has also doubled its call-in center staff for Florida, said Jon Urbanek, senior vice president for commercial markets.

"The law has been passed. Our job is to make it work to the best of our ability," Urbanek said.

The state's attitude is not necessarily the same. Scott and legislative leaders continue to oppose Obamacare. This week, the state Department of Health, citing "privacy concerns," banned the navigators from soliciting uninsured Floridians at the places they are mostly likely to currently seek health care: county health centers. The news drew a quick rebuke from federal officials.

"This is another blatant and shameful attempt to intimidate groups who will be working to inform Americans about their new health-insurance options and help them enroll in coverage, just like Medicare counselors have been doing for years," HHS spokesman Fabien Levy said.

Copyright Orlando Sentinel 2013

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