Pete, Obama Care, and the NAACP

Fellow Libertarians,
I went to an Affordable Healthcare Act information meeting sponsored by the Okaloosa Chapter of the NAACP yesterday.  (24 Sep 13)
Here are my notes in bullet form.  34 people in attendance.
The players:
Overall organization paying for this presentation…Get Covered America…a 501(C)3 org.   Private organizations assisting GCA are the NAACP, Planned Parenthood and Catholic Charities, among others.
Raymond Nelson…local NAACP chapter President (Sabu Williams, former President, will be leaving Okaloosa for work reasons on 1 Oct)
Christina Swodowski…Team leader and spokesperson with Enroll America…area of responsibility Jacksonville to Pensacola
Tony Pena…Community Organizer for Enroll America
Drew Roberts and one other unknown person are with the Barnes Insurance agency…a private firm that is apparently assisting ACA presentations
Stacey Ray…Project Director with Families Count,  based in Pensacola…an ACA “Navigator”…She gets paid by a grant from South Florida University who are in turn paid by a Federal grant to SFU.  She does not get paid by the number of applicants she finds.
The Presentation:
1) Ray Nelson – The ACA is law of the debates tonight
2) Tony Pena opened with a couple of insurance nightmare stories including one about his own son who “would have died were it not for insurance”
    a) My son is now uninsurable due to a pre-existing condition (Krohn’s Disease)
    b) ACA is no longer debatable…it is law of land…
    c) ACA expands health coverage to up to 45 million people, up to 3.9 million in Florida alone
    d) Pre existing conditions go away
    e) Individuals may qualify for subsidies from the Feds based on income
    f) All approved insurance plans must cover
            – Doctor visits
            – Hospitalizations
            – maternity
            – Emergency room visits
            – Prescriptions
    g) All policy plans must be in plain language
    h) demographics on the uninsured
            – young, poor to lower middle class, Black and Hispanic, little to no college education, more men than women uninsured
    i) Mr. Pena has encountered many people with Bentleys and Jags in driveway that have no health insurance
    j) Mr. Pena said the ACA was “a sea change in the way America views health insurance.”
    k) Mr. Pena said that blacks and Hispanics without health insurance should be understood “without saying…”
    l) There are rumors in some communities the gov will implant people with chips or prosecute people because they are drug users…not true
    m) 17% of insurance applicants are denied for pre-existing conditions
    n) 60% of the uninsured do not know what their options are.
3) Christina Swodowski
    a) Those eligible…citizens, no prisoners or illegal immigrants (later…veterans with dishonorable discharges are eligible)
    b) Open enrollment starts 1 Oct 2013 and goes until 31 March 2014.  Everyone must choose a plan of some sort by then.
    c) A person can get government subsidies if their income is less than 400% of federal poverty line
            – $44,680 for single person
            – $92,240 for a family of four
    d) Insurance premium refunds come right away under the Advance Pay Federal Tax Credit (APFTC)
     e) When you apply the only health question asked is if you are a smoker
    f) Consumers choose their plan – all approved plans will be laid out together like Expedia does travel plans
            – Complete application on-line, via phone or mail and choose plan
            – Navigators will be available to provide unbiased assistance
4) Ray Nelson – much of what he said was from a prepared presentation from a Mr. McKnight who could not attend that evening
    a) Medicaid cannot continue the way it is now
    b) 4 doctors in Crestview retiring this year, 3 at Hurlburt (pjb note: although he did not say how the ACA solves this)
    c) there are more and earlier chronic diseases
    d) Exercise, eat less, cut out alcohol
    e) Take advantage of preventative health care… the ACA provides for no co-pay for the first three preventative health care visits
    f) People were using the emergency room as their primary healthcare…very expensive
Questions from the audience:
? – I have a plan, must I choose from a plan doctor?
    ans – Yes, but we do not know all the doctors that are participating in the various health plans
    ans – Barnes Insurance Agency – Florida Blue is the only currently approved health plan for Okaloosa County
? – Does Florida Blue have a monopoly?
    ans – Barnes – other counties might have other plans
? – Estimate of what plans will cost?
    ans – Barnes – rates yet to be seen, and we are only six days away from enrollment
? – I am confused.  I have a plan but my doctor said I might have to give it up.  Why?
    ans – Not all plans have approved features and will not be allowed
    ans – Sabu Williams – you may get better coverage at a cheaper price
? – How much info will be provided on companies at the “exchanges’?
    ans – Tony Pena – think of it as Expedia with all options and cost laid out side by side
    ans – Tony Pena- Costs – if your policy costs $150 per month, and your income allows a subsidy of $100, your payment is $50
    ans – Barnes – Bronze, silver, gold plans will cost more
? Everything is based on income. What if I get a job?
    ans – Stacey Ray – renewals are by year…if you have a higher income you must present documents to show it… more income at renewal time affects Florida CHIP program too
? No job – how do I get insurance?
    ans – Tony Pena – at exchange website you will be directed to Medicaid.
    ans – Stacey Ray – Florida did not expand Medicaid, so there will be a gap between Medicaid threshold and the current Federal affordable lower limit.  You my have too much money for Medicaid assistance, but too little to qualify for an                 exchange approved plan.
    ans – Stacey Ray – There will be penalties if you can afford insurance but do not purchase it
? Is there a progressive penalty for not enrolling?
    ans – Stacey Ray – If you do not enroll, you will be penalized.   Penalty rates are low in 2014 but get progressively higher until 2016  (pjb note:  a few numbers thrown around and I think I heard $600 per person in 2014 moving up to $2500 per person in 2016.  Mind you, I don’t have the world’s best ears, and a lot of side conversations got started)  [From Dave and Rebecca Sherry 25 Sep 13…A bronze plan is expected to cover 60% of out of pocket costs.  Silver, same at 70%, gold, same at 80%, and platinum is expected to cover 90%.  There is no 100% out of pocket cost option.  It was reported today that in the U.S. the average mid-level premium is expected to be $328 per person per month…Regarding the penalties.  The first year, 2014, the penalties are $95 or 1% of income, whichever is HIGHER.  In 2015, the penalty is $325 or 2% of income, whichever is HIGHER.  In 2016 the figure is $695 or 2.5% of income, whichever is HIGHER.  The figure is adjusted for inflation after 2016.]

? Once you have a premium, do you pay every month?
    ans Yes
? Do you have to do anything if you are covered now?
    ans – Stacey Ray – No, but if it is not an approved policy it will go away
? Most plans pay 80% of costs.  Will this pay 100%?
    ans – Stacey Ray – depends on the plan you choose (pjb note: which in Okaloosa, currently, is only Florida Blue)
? How do plans tie into catastrophic policies?
    ans – Stacey ray – Catastrophic polices may be a thing of the past, because all plans must have the basic features outlined earlier
? Some people are afraid of computers.
    ans – You can do paper and telephone applications too.  Navigators will not have access to private information, and they will be licensed.
    ans – Sabu Williams – The ACA is not insurance, it is access to insurance
? Are the plans transportable across state lines?
    ans – Tony Pena – I don’t know
    ans – Barnes – You will get an opportunity to enroll in your new state
? If I live in Okaloosa, can I enroll in another county?
    ans – No, process is based on residence zip code
? – (pjb note; my question) Will cash only doctors be allowed to operate?
    ans – Stacey Ray – “Concierge doctors” will still be allowed to operate