Lowers the uninsured rate. Gallup recently estimated that the uninsured rate in Florida in 2015 was 15.7 percent, down from 22.1 percent in 2013.
Prohibits coverage denials and reduced benefits, protecting as many as 7,838,642 Floridians who have some type of pre-existing health condition, including 960,492 children.
Eliminates lifetime and annual limits on insurance coverage and establishes annual limits on out-of-pocket spending on essential health benefits, benefiting 5,587,000 people in Florida, including 2,170,000 women and 1,411,000 children.
Allows states to expand Medicaid to all non-eligible adults with incomes under 133 percent of the federal poverty level. If Florida expands Medicaid, an additional 750,000 uninsured people would gain coverage.
Establishes a system of state and federal Health Insurance Exchanges, or Marketplaces, to make it easier for individuals and small-business employees to purchase health plans at affordable prices. During the open enrollment period for 2016 coverage, 1,742,819 people in Florida selected a plan through the Marketplace, including approximately 731,984 new consumers and 487,989 young adults. In Florida, 82 percent of Marketplace consumers could have selected a plan for $100 per month or less after tax credits for 2016 coverage.
Created a temporary high-risk pool program to cover uninsured people with pre- existing conditions prior to 2014 reforms, which helped 11,873 people in Florida.
Creates health plan disclosure requirements and simple, standardized summaries so 7,731,600 people in Florida can better understand coverage information and compare benefits.
Requires health insurers to provide consumers with rebates if the amount they spend on health benefits and quality of care, as opposed to advertising and marketing, is too low. Last year, 821,814 consumers in Florida received $59,908,232 in rebates. Since this requirement was put in place in 2011 more than $2.4 billion in total refunds have been paid to consumers nationwide through 2014.
Eliminates out-of-pocket costs for preventive services like immunizations, certain cancer screenings, contraception, reproductive counseling, obesity screening, and behavioral assessments for children. This coverage is guaranteed for 7,289,873 people in Florida, including 3,024,126 women.
Eliminates out-of-pocket costs for 3,070,451 Medicare beneficiaries in Florida for preventive services like cancer screenings, bone-mass measurements, annual physicals, and smoking cessation.
Phases out the “donut hole” coverage gap for nearly 355,360 Medicare prescription drug beneficiaries in Florida, who have saved an average of $987 per beneficiary.
Creates Accountable Care Organizations consisting of doctors and other health-care providers who come together to provide coordinated, high-quality care at lower costs to 550,728 Medicare beneficiaries in Florida.
Phases out overpayments through the Medicare Advantage system, while requiring Medicare Advantage plans to spend at least 85 percent of Medicare revenue on patient care. Since 2009, Medicare Advantage enrollment has grown by 738,237 to 1,676,049 in Florida while premiums have dropped by 10 percent nationwide.
We’re not done. Other legislation and executive actions are continuing to advance the cause of effective, accountable and affordable health care.This includes:
Advancing innovative care delivery models and value-based payments in Medicare and Medicaid. The Administration set goals of tying 30 percent of traditional Medicare payments to alternative payment models by the end of 2016 and 50 percent by the end of 2018, and met its 2016 goal 11 months early.
Proposals to invest in targeted research and technologies to advance the BRAIN Initiative, Precision Medicine Initiative, and cancer research.
A new funding pool for Community Health Centers to build, expand and operate health-care facilities in underserved communities. Health Center grantees in Florida served 1,197,948 patients in 2014 and received $502,975,163 through fiscal year 2015 under the health care law to offer a broader array of primary care services, extend their hours of operations, hire more providers, and renovate or build new clinical spaces.
Health provider training opportunities, with an emphasis on primary care, including a significant expansion of the National Health Service Corps. As of September 30, 2015, there were 354 Corps clinicians providing primary care services in Florida, compared to 167 clinicians in 2008.