Hello and happy Friday.
Despite an ongoing legal challenge --- and constant criticism from many Florida politicians --- a key moment is coming up for Obamacare.
Open enrollment in the federal health exchange for 2021 health care coverage begins Sunday, Nov. 1, and ends Dec. 15.
Jodi Ray, executive director of the Florida Covering Kids and Families program at the University of South Florida in Tampa, says she doesn’t know quite what to expect Sunday morning when open enrollment begins, but she is expecting interest to be high.
After all, no state has had greater enrollment in the federal health exchange than Florida. There were about 1.9 million Floridians enrolled this year.
“Despite it not being a politically inviting environment for the ACA, Floridians on the ground wanted coverage and access to coverage,” Ray told The News Service of Florida, referring to the Affordable Care Act, commony known as Obamacare.
And she doesn’t expect COVID-19 or a pending U.S. Supreme Court hearing over the constitutionality of the federal law to change that.
Ray’s group spearheads the state's health exchange enrollment navigation efforts.
Navigators are established in the federal law as advisors who help people traverse what can be difficult terrain: securing health insurance.
Navigators can be individuals or organizations. They are trained to help people considering health-coverage options through the federal exchange, including completing eligibility and enrollment forms. Navigators are required by law to be unbiased.
Ray, who subcontracts with seven advocacy organizations across the state to provide navigator services, says she and others have been busy since the 2020 open-enrollment period ended because the coronavirus pandemic quickly followed. More than 1 million Floridians lost their jobs as a result of the virus, and many of them also lost their employer-sponsored health insurance.
The 2010 Affordable Care Act put into federal law standards that health insurance companies and HMOS must abide by and precluded states from weakening those standards.
The federal law requires health insurers to offer policies to people regardless of pre-existing conditions and prevents companies from charging rates based on health factors. The law also authorized states to expand Medicaid to low-income childless adults --- which Florida has not done --- and established a federal health-insurance exchange where people can purchase subsidized coverage.
The exchange, operated by the federal government, is where low-income individuals can purchase insurance and obtain subsidies to help pay for the coverage. The federal law allows people to apply for coverage on the federal exchange after open enrollment ends, under certain circumstances such as loss of employment.
“We have had a steady rate of enrollments since (2020) open enrollment ended. We didn’t have any deficits in enrollment. We have been busy,” Ray said.
Ray said her office has been fielding questions from state residents who lost their jobs and their health insurance while also hearing from residents of New York and California who are considering relocating Florida, where it is less expensive to live.
“You can’t afford to be out of work and live in states like that,” she said.
Ten health insurance companies and HMOs are participating in the federal exchange this year. Blue Cross Blue Shield of Florida offers policies in every county, the only carrier to do so. Celtic Insurance Company offers policies in 63 counties but does not offer health insurance to residents of Hendry, Martin, Monroe and Taylor counties.
More insurance companies are offering plans during the 2021 open-enrollment period but the cost of coverage will be slightly higher, mostly attributable to the COVID-19 pandemic. Florida Insurance Commissioner David Altmaier approved a 3.1 percent increase for the 2021 rates.
Ray’s group already had embraced virtual platforms to assist in their enrollment efforts prior to the coronavirus pandemic, in response to President Donald Trump's drastic reduction in the amount of federal funding to support navigators.
“We developed that two years ago so when COVID-19 hit, we were already doing that. I think that allowed us to seamlessly move into the new way of doing things,” said Ray, whose group received a $1.6 million grant from the federal government.
But navigators still offer face-to-face appointments for people who need assistance, Ray said.
“Navigators don’t do this work because it’s a good time. It’s hard work. It’s mentally exhausting. It’s physically exhausting. We are entering into what is equivalent of tax season for accountants for that six weeks. And the prep that goes into it is a lot of hard work as well," said Ray, who has worked to help people find access to health care for more than 20 years. "It’s not exactly a high-paying job. It’s not like being an accountant. And yet you have people who do this work not only because not only they are passionate about it but because they have a lot of compassion for the people they are trying to help. ... When it comes down to it, we can talk about health insurance all we want. But we are trying to give people access to health care. When you think about it that way, it’s a lot more important that just narrowing it down to ‘health insurance.’ Health insurance isn't a sexy topic, you know.”
RULES
The Board of Psychology proposes amending Rule 64B19-11.0035 to update language regarding education accreditation for determining eligibility for examination. More here.
The Board of Nursing proposes amending Rule 64B9-4.001 to add the definition of primary care practice. More here.
The Board of Pharmacy proposes amending Rule 64B16-28.108 regarding labeling of medicinal drugs. More here.
The Board of Pharmacy proposes amending Rules 64B16-26.300 and 64B16-26.301 to update consultant pharmacist licensure requirements. More here.
The Board of Physical Therapy Practice proposes amending Rule 64B17-5.001 to temporarily waive the in-person requirement for continuing education. More here.
The Board of Physical Therapy Practice proposes amending Rule 64B17-7.0027 to update the application form to be used by licensees completing the board's laws and rules exam. More here.
The Board of Physical Therapy Practice proposes amending Rule 64B17-6.001 to clarify the minimum standards of practice in physical therapy in terms of sexual misconduct, the supervision of students in telehealth situations, and the need to keep complete and accurate medical records. More here.
The Board of Physical Therapy Practice proposes amending Rule 64B17-9.001 to allow for all 24 hours of continuing education to be home study through the November 2021 biennial renewal, clarify terminology, and update the continuing-education laws and rules application form for continuing-education credit. More here.
The Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling proposes amending Rule 64B4-7.0081 regarding requirements to be a qualified practitioner for completing risk assessments and treatment of sexual offenders. More here.
The Board of Speech-Language Pathology and Audiology proposes amending Rule 64B20-4.001 regarding the certification of assistants. More here.
LOBBYISTS
Brian Ballard and Mathew Forrest have registered to lobby for Curative, Inc.
Marti Coley Eubanks has registered to lobby for Jackson Hospital.
Michael Fischer and Doug Holder have registered to lobby for Medical Conservation Devices.
WEEK IN REVIEW
—Go girl ... Colleen G. Koch was named Friday as dean of the University of Florida College of Medicine, marking the first time in its 64-year history that the medical school has been headed by a woman. More here.
—Looking at the numbers ... COVID-19 is claiming more lives than official data indicates. More here.
—Who does this? ... Thieves steal 6 million medical gloves from Florida supplier. More here.
—Question time ... Will Florida keep funding local coronavirus tracing? The state won’t say. More here.
—Looking for answers ... The family of a Latino former Obama official suspected he died of COVID-19. They were right. More here.
—Positivity ... Florida changes coronavirus data on the percent of tests coming back positive. More here.
—The stakes ... Obamacare lawsuit threatens health care coverage for 2 million Floridians, and maybe millions more. More here.
—Delays ... Coronavirus test results still taking days for many Floridians. More here.
—Warning time ... Florida hospitals on high alert as feds warn of cyber attacks. More here.
—Court battle ... Mid-Florida Cancer Center scores a partial win in AdventHealth lawsuit. More here.
—Accessible, not affordable ... If the Trump administration and a group of states, including Florida, successfully scuttle Obamacare after next week’s election, the Republican-controlled state Legislature has a plan. Sort of. More here.
—What's the plan, man? ... Florida plans to prioritize COVID-19 vaccinations for front-line workers at hospitals, nursing homes and senior centers and first responders when a vaccine becomes available. State officials outlined a three-phase vaccination rollout under a draft plan Florida was required to submit to the federal government this month. More here.
—Fingers crossed ... People who received flu vaccinations in the year before testing positive for the novel coronavirus were nearly 2 ½ times less likely to be hospitalized for COVID-19 and more than three times less likely to be admitted to a hospital intensive care unit, according to a University of Florida study published Wednesday in the Journal of the American Board of Family Medicine. More here.
—Can't sue the "U" ... University of Miami is shielded from a medical-malpractice lawsuit stemming from care provided by one of its physicians at the public Jackson Memorial Hospital. More here.
—More contagion ... Florida has recorded nearly 900 cases of hepatitis A this year, a sharp decrease from last year --- but far more than in most years. More here.
CALENDAR
Nov. 2
1 p.m. The Florida Board of Nursing meets. Call (888)-585-9008; participant code: 275112502. Agenda here.
Nov. 3
ELECTION DAY --- VOTE!
Nov. 4
9 a.m. The Office of Statewide Research meets. Call (888)-585-9008; participant code: 852642835. Email IRB@flhealth.gov for a copy of the agenda.
10:30 a.m. The Board of Medicine Electrolysis Council meets to discuss proposed Rule 64B8-56.002. Call (888)-585-9008; participant code: 564341766.
Nov. 5
8 a.m. The Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling meets. Call (888) 585-9008; participant Code: 123475828. Agenda here.
9 a.m. The Board of Pharmacy meets to review cases where probable cause has previously been found. Call (888) 585-9008; participant code: 599196982. Agenda here.
10:30 a.m. Health, Dietetics and Nutrition Practice Council meets. Meeting link here. Call (850) 245-4373 for a copy of the agenda.
1 p.m. The Brain and Spinal Cord Injury Program Advisory Council Outreach Committee meets. Meeting link here. Or, call (850) 792-1375; participant code: 908341597. Email Teresa.George@flhealth.gov for a copy of the agenda.
Nov. 6
9 a.m. The Board of Dentistry Probable Cause Panel meets to consider cases where prior probable cause has been found. Call (888) 585-9008; participant code: 599196982. Agenda here.
1:30 p.m. The Board of Nursing North/Central Probable Cause Panel meets to consider cases where probable cause has been found. Call (888) 585-9008; participant code: 275112502. Agenda here.
2:30 p.m. The Board of Medicine Probable Cause Panel South meets. Call (888) 585-9008; participant code: 432162565. Agenda here.