Obamacare has turned 5 and the journey has been far from comfortable. Fortunately amid challenges from opposition, a dysfunctional initial rollout, and slow acceptance of the law, Obamacare has still achieved what it set out to five years earlier, even if there is a lot more ground to cover in the coming years. Owing to the law, the US healthcare industry has seen massive improvement in the way healthcare is availed. At the completion of five years, here are 5 numbers that show the major strides of the government, the impact of the law, and the avenues that require attention in the coming years.

1) 16.4 million have enrolled through Obamacare marketplaces – The biggest achievement the ACA has delivered is the mammoth 16.4 million enrollments through the exchanges in two open enrollment seasons. When ACA was implemented, 47 million people did not have health insurance. Although the number continued to grow over the years, 16.4 million of those people found affordable health insurance through exchanges. Out of these, as many as 85 percent were able to avail subsidies and cost assistance from the government for keeping their health insurance premiums in check.

2) $7.4 billion dollars were saved by Hospitals in uncompensated costs – Combining the effect of health insurance marketplaces and Medicaid expansion, hospitals have been able to save $7.4 billion in uncompensated costs. Before ACA, hospitals have covered insurance care for uninsured and underinsured. Hospitals delivered about $50 billion in uncompensated care in 2013. Medicaid expansion under ACA has also played a major role in cost savings. For instance, states that expanded Medicaid experienced a 26 percent reduction in their costs, while states that did not expand Medicaid experienced only a 16 percent reduction.

3) 29 States and DC expanded Medicaid to complement the coverage net of ACA – Medicaid expansion was a crucial aspect of the working of the ACA. Although the U.S. Supreme Court shot down the mandatory expansion of Medicaid under ACA, it left states with a choice to support the law through expansion. 29 states and DC expanded Medicaid to cover healthcare costs, and these states were able to observe a huge improvement in their healthcare cost savings and coverage net. People did not fall into the coverage gap, which opened up in states that decided not to expand Medicaid.

4) $88 billion  has been foregone by States that decided not to expand Medicaid – The remaining states which decided not to expand Medicaid left their residents between a rock and a hard place. At the same time, these states let go of $88 million  in federal grants, which they would have received between 2014 and 2016 if they had decided to expand Medicaid in their state. With a limited healthcare system of these states, residents will be less likely to use medical services, which would ultimately impact the contribution to national economic growth. Without Medicaid, a lot of people will not use medical services, and this will play a detrimental role in the coming years. For instance, by 2023, Florida will lose out on $270 billion national economic impact because it did not expand Medicaid.

5) $1.2 trillion will be Obamacare’s cost for the next decade – Owing to a close check on healthcare spending and healthcare costs, Obamacare will be costing about 11 percent less than earlier estimates. Over the next decade, $1.2 trillion will be spent on Obamacare. Other than the control of ACA on healthcare spending, lower costs of health insurance subsidies will contribute to lower spending. Assuming that the law lasts for that long and is not strangled by the Republican repeal efforts, there is a lot Obamacare can change in the healthcare system.

A repeal of the ACA has probably been a singular focus for the Republicans since 2010, ever since they launched their first attempt to replace the law with their alternative. After countless attempts to repeal and replace the Affordable Care Act, the GOP had to bow down to the ultimate success gathered by the law after a botched rollout last year. With formidable enrollment numbers and extended benefits through the law, it seemed nearly impossible for the GOP to take the law down in time.

However with a Republican-majority Senate, it looks like they have a strong opportunity to put their old plan in action and replace ACA with something endorsed by the party. The GOP taking a different approach to tearing ACA apart bit by bit – targeting the most unpopular provisions of the law and splitting them open with targeted legislation that could gather sufficient momentum. Here’s what could happen to Obamacare if a GOP Senate gets its way.

With this majority, the GOP plans to put in resolutions to repeal the entire law and, if that does not work, targeting the major taxes and penalties under Obamacare that are inacceptable to the party. The GOP still feels that it is necessary to break the law down as some provisions of ACA are mere unworkable expansions that will increase healthcare costs across the country, and will hurt employment, economy, and business growth.

The section of ACA receiving the strongest ire from Republicans is the employer mandate. The employer mandate requires businesses with more than 50 employees to provide health insurance coverage to employees, failing which they will be subject to penalties. The GOP feels that these aspects are hurting job growth in our economy, in turn hurting our people. Other than the workings of the employer mandate, the Republicans also want to target the gray area presented by the definition of ‘fulltime’ workers in ACA. Other than these primary aspects of the law, the Republicans will also focus on excise tax on medical devices, CAT scan machines, MRI machines, etc. The compensation for market losses to health insurers might also come in the line of fire.

The Republican efforts are drawing power from the business community’s constant lobbying efforts against employer requirements, penalties and taxes. Medical device manufacturers have continually spoken against excise duties, giving more firepower to Republicans. Amid this, some Democratic senators have also discussed supporting certain Republican measures. It looks like once the repeal efforts come to play, some negotiations might be possible between Republicans and Democrats, and the White House might not be able to veto every move of Republicans.

There are chances of a middle path being established on some attacks by Republicans, for instance, the tax penalties on employers who do not offer health coverage to employees might be replaced by incentives for employers who do. While the all out Obamacare repeal agenda will definitely be pushed off the floor, the seemingly minor alterations to the law might not be that easy to forgo.

As the ACA faces another Supreme Court case where the federal subsidies in states that did not opt for their own exchange are being reconsidered, this looming challenge might be a tough nut to crack. Unfortunately, a powerful act that has the potential of changing health insurance forever might succumb to mounting pressure from the opposition.

There is a new entrant in the list of challenges to Obamacare – a new challenge that limits the ability of Obamacare to provide subsidies to people buying health insurance off the federal marketplace, healthcare.gov, operating in more than 30 states. According to this new challenge, the language of the Affordable Care Act is such that it does not allow the Obama administration to provide federal subsidies to eligible people buying health insurance off the federal exchanges.

However if eligible consumers purchase insurance off state exchanges, only then can the government provide them subsidies. The Supreme Court has announced that it will be listening to the challenge, and if a resolution banning subsidies from federal exchanges comes to pass, a huge blow will be delivered to the ACA and Obama administration.

The Obama administration feels that the case is without merit and the ACA enables them to provide subsidies throughout the nation across both federal and state exchanges. The case, known as King v. Burwell, is similar to the Halbig v. Burwell case earlier this year, when the Court ruled against the government 2-1.

However, this time, the Obama administration, most likely, can last through the ordeal. Here are 9 reasons why:

1)    When ACA was established, one thing was crystal clear that without the support of subsidies, the insurance market will not be stable under the law. The law would go into a death spiral and collapse before making any difference to the health insurance market.

2)    When ACA was signed into a law, the states had an option to either establish their own exchange and receive federal subsidies or let the federal government integrate them with the marketplace they were creating. At that time, no state considered the chance that by letting their taxpayers shop on the federal exchange, they would be denying them a chance to get subsidies in the future.

3)    Naturally, the design of the law will not forgo such a substantial and important aspect by mentioning it in an ambiguous and trite manner. Naturally, the lawmakers did not design the law as the challengers are mutating it to be.

4)    The popular opinion on the law is not concerned with the fabricated ambiguity that the challengers have put forward, they are just concerned with the simple and pure meaning that federal subsidies are available to everyone, be it through federal exchange or the state exchange.

5)    The IRS and HHS have both constructed the statute and have found it to be perfectly coherent and consistent with the original statute intention.

6)    The challengers project that the health insurance exchange run by federal government should not be allowed to impart subsidies, as it is not established in the state. By that logic, if the federal exchange is not running in the state, a citizen of that state should not be allowed to purchase health insurance through the federal exchange.

7)    ACA’s purpose will fall apart if the people shopping through those exchanges in 34 states which went with the federal exchange would not be allowed to avail the shield of subsidies.

8)    If the Supreme Court agrees with the challengers, the same ACA which is helping residents in these 34 states get better health insurance will transform into a mandate that will dramatically impact the lower income groups by taking away subsidies.

9)    The implication is that the Congress wanted the insurance markets to collapse in states, which decided to default to the federal exchange.

Although the Supreme Court is considering the case, it is a question of semantics that has caused this major headlock between two parties. While the nine reasons are not legally based arguments, they do raise important issues. This latest challenge, and ruling, will be interesting to watch, to say the least.

Since its enactment in 2010, the Affordable Care Act has come a long way in pursuit of its primary goal of a fully insured America. When the ACA was rolled out, it aimed to provide affordable health insurance to 32 million people by 2019. To realize that goal, the administration worked on a variety of initiatives, such as the setup of state and federal marketplaces that helped customers to shop for health insurance in a consumer centric marketplace format. The expansion of Medicaid was proposed to assist the momentum built by the ACA, and the health insurance industry was realigned to cut costs and suit the workings of the law.

In the last 5 years, ACA has had some hits and some misses in its journey. Today, we take a look at the top ten hits and misses in its 5-year journey.

1)  The Obama administration established the federally facilitated marketplace (aka healthcare.gov) that helped states without their own exchange offer subsidized health insurance to their citizens. For states that established their own state exchange, the Obama administration offered monetary support through grants that helped states pay for the exchanges. Although these exchanges struggled in the first 3 months, they delivered a solid enrollment figures when the first open enrollment ended in March 2014.

2)  As per the first enrollment, the administration was able to enroll 8 million even after suffering major setbacks in the first three months of enrollment. The majority of these enrollments were done over the phone or by paper apps.

3)  As many as 87 percent of the enrollees were able to control their health insurance costs through the exchange provided subsidies. These subsidies worked to minimize the cost of health insurance for people up to 400 percent of the federal poverty level, thus helping families cover for their health insurance. With removing the pre-existing condition, the ACA opened doors to people who had trouble finding insurance.

4)  By the end of the second open enrollment period in February 2015, the Obama administration managed to enroll 11 million people through the exchanges. Although a large chunk of these enrollments were people who had enrolled last year, deeper penetration of the law in the market was prevalent.

5)  It is expected that about 85 percent of the new enrollees will be eligible for the health insurance subsidies. Owing to the subsidies and the interest of healthy individuals in the law, the premium rise in the year 2015 was marginal.

6)  However, it seems that there will still be around 30 million uninsured Americans by 2019. If healthy individuals start dropping their health insurance, this number might go up, thus destabilizing the market and opening it for more challenges in terms of insurance pool balance.

7)  The ACA was built with concept of parallel expansion on Medicaid to cover some sections of the public. Since some states chose to not expand Medicaid, about 5 million people are stuck in a coverage gap, which prevents them from getting subsidies to cover their insurance costs from the exchanges nor are they eligible for Medicaid.

8)  Although health insurers are working with the law to provide affordable coverage, they have resorted to alternate measures to keep their profit margins. A lot of health plans have narrowed their networks and connected with low cost hospitals and physicians.

9)  Due to subsidies is such that people are choosing mid-tier silver plans, which ultimately cost a little higher but offer better cost assistance to consumers. However, the Silver plans expose the consumers to 30 percent of their healthcare costs, while 70 percent is covered by their plan, but most of these people cannot afford that remaining cost, and ultimately risk dropping their coverage and incurring significant medical debt.

10)  The shortage of primary care physicians is another challenge. The country is short of about 45,000 physicians, and most of the existing ones are no longer accepting new patients.

A hacking incident (or rather, a five year long breach) at Community Health Systems, disclosed in August 2014, is supposed to have resulted in the leakage of 4.5 million health records.  Why on earth, one might be excused for asking, would someone steal health records?

Privacy

Let us first clarify the simpler matter that medical records are certainly worth protecting.  They contain private information about an individual.  Though most medical conditions say nothing about someone’s character or personality traits, there are still good reasons to want to keep one’s medical history private.  One may not want the world to know that one suffers from irritable bowel syndrome, or that one has suffered a few miscarriages, or even that one has had LASIK done to cure one’s eyesight.  You feel  comfortable in telling all to your doctor because you are assured that that information will be held in confidence.

Most people feel slightly embarrassed about having to explain an ailment to their doctors.   Imagine how much harder it would be for them if they knew that the doctor was going to put all that information in the public domain!

Other than privacy, is there any other reason to keep medical records secret?  Other than gossip and ridicule, what else does one have to fear?

Security

A lot, as it turns out.

The business of healthcare has become extremely complicated in the 20th and 21st centuries.  We have transitioned from a close relationship with the town or village doctor to a network of clinics, hospitals, providers, specialists, laboratories, pharmacies, medical device manufacturers and vendors, insurance carriers, government subsidies, medical tourism destinations, and so on.  It is all a rather dizzying array of complexity.

These entities exchange medical and payment information.  Usually, but not always, the payment is released by an insurance carrier.  In some cases, the payment might also be requested from an employer or the government.  It is quite difficult to impersonate someone to their employer, but most dealings with the government or with a large insurance provider are faceless.  All that matters in these interactions is whether one knows some important identifying numbers.

It is those numbers, and the history of one’s health conditions, which can enable hackers and thieves to fraudulently bill on your behalf.  Let us say a hacker knows that you are suffering from mild hearing loss.  The hacker might order a $20,000 hearing aid and bill your insurance carrier for it, and then sell it in the black market.  He might even be willing to make the co-payment.  Or, let’s assume a hacker figures out that you have Coronary Artery Disease (CAD), which might benefit from angioplasty.  What is to stop a hacker from creating the records of an imaginary angioplasty at, say, an “out-of-network” clinic (perhaps in another country) and bill your insurance carrier for hundreds of thousands of dollars?

To be sure, most medical histories do not lend themselves easily to lucrative exploitation.  Hence, it is very rare (unheard of, actually) that hackers will specifically target someone’s medical records.  Usually hackers attack a whole system and steal thousands or millions of records.  Then these are sold in bulk to specialized gangs which then sift through the information looking for opportunities.

“Ask for his ID!”

Shouldn’t it be required for the paying entities to authenticate the bill and the patient?  Well, they do.  But in today’s world, information is identify.  If you know enough about someone, you can, for all intents and purposes, become that person.  Their date of birth, their family history, their physical characteristics, even their biometric parameters (fingerprints, etc.) can be transmitted in such a way that there is no cause for suspicion that the transmitter is anyone other than who he says he is.

Banks and credit card companies have elaborate algorithms to detect when a transaction does not fit the pattern.  Unfortunately, health providers and insurance companies have not yet invested in such technologies.  And given the vast complexity of the human body, and the close relationship ill health has with suffering, it is doubtful if suspicion at a new symptom or a treatment is going to be welcomed by patients.  Such algorithms (at banks) fail, for example, when somebody suddenly has to travel to a location far from one’s normal place of business.

Healthcare is already riddled with too much paperwork.  And unlike financial transactions, health paperwork (e.g. diagnostic information) can be astoundingly varied and immune to simple algorithms.  To automatically scan all this complex data to detect fraudulent activity is not a simple project.

Therefore, the need is to protect the data in the first place.  If the data does not get into the wrong hands, hopefully we can prevent fraudulent billing.  Also, unlike financial information such as credit card numbers, stolen medical records continue to remain valid.  Its protection is therefore even more important.

Over the last quarter, as 8 million Americans enrolled in health insurance through Obamacare, surveys and initial reports have highlighted a heartening trend – Americans are showing increasing interest in the new, subsidized health insurance and the rates of uninsured are currently at their lowest since 2008. Newly insured individuals are showing the most activity with their health insurance, spiking collective interest of the nation in post health reform market. Combined with the steadily dropping uninsured rates, surveys indicate that ACA is finally working in its most crucial departments.

Picking up the number of uninsured, 18 percent of Americans were uninsured in 2013. By 2014, this number dropped to a new low of 13.4 percentage. In the age group of 19 to 64, 9.5 million people shed their uninsured status. The strongest surge in the number of insured came in the 19 to 34 years age group, roughly 28 percent, which translates to 5.7 million more young adults with health insurance in 2014 than in 2013. The same trend is prevailing in the Medicaid sphere too, with expansion increasing the reach of the program, 6.7 million people have been able to enroll into the expanded Medicaid. For May 2014 alone, the enrollment was roughly a million.

Other than the lowest uninsured rates, the Obamacare health insurance is seeing quite a lot of activity too. According to available data until May 2014, as much as 60 percent newly insured adults have made use of their health insurance either through a clinic visit, a hospital visit or a prescription. Of these, 62 percent people admit that they could not have availed these medical facilities before the Obamacare insurance. The newly insured are showing a solid preference to the insurance available under ACA, and this is featuring in the collective opinion America has of the law.

Although the sentiment toward the law is becoming positive, 45 percent Americans still think ACA is making matters worse for them. At the start of 2014, this number was 50 percent. Similarly, nearly 60 percent of people newly enrolled in either Medicaid or private exchange health insurance feel that they are getting access to healthcare that was previously out of their reach. Additionally, 78 percent of people newly insured under ACA feel satisfied or extremely satisfied with the health insurance benefits available to them. As many as 60 percent people with new health insurance have started using their insurance benefits, and most were able to find a doctor and book an appointment with ease and within a two week period. These numbers show an increasing popularity of the law, and, most importantly, a wider acceptance of the benefits available to people in post ACA health insurance market.

Other than enrollee appreciation and acceptance, health insurance plans are also showing wider acceptance of the law. Available data shows that new carriers are interested in offering health insurance across states by 2015. As of now, most carriers are planning to widen their offerings in the coming year. With more players entering the market and existing ones revamping their bouquet of offerings, the market will experience competition that will bring better benefits, wider coverage at a better price to enrollees. Collectively, the number of uninsured is dropping in the country and people with new health insurance are showing increasing interest in these new health plans. With new enrollees showing exceptional interest in the available health options, the popularity of ACA is increasing. As the number of uninsured drops further, the Obama administration will move closer to its primary goal of providing health insurance to everyone in the country.

While lowering uninsured rates and rising individual interest are important factors, for achieving this mammoth goal, the administration needs to have a few more tricks up its sleeves. For instance, communities that are still disconnected with the benefits of ACA need extensive motivation to sign up and enroll. Ironically, these communities are the ones that typically need ACA health benefits the most. Although a prospect of alternative to Obamacare has long been in the works for Republicans, it seems that Obamacare is already doing better than any alternative the GOP proposes to replace ACA. ACA is definitely working, but a better way to take things forward would be to close the loopholes of ACA and make it reachable to communities, for instance the 45 percent which sees ACA as a bane, that have been distant from the benefits of Obamacare.

As the Affordable Care Act goes into the waning days of its second open enrollment, the pressure is building on the U.S. healthcare system. More people have health insurance than ever, and this number is expected to continue to increase in the coming few months. In fact, for the 6.7 million people who purchased health insurance in the first enrollment period finding a primary care physician is getting difficult. Simply put, there are not enough primary care doctors to support the increasing number of people with health insurance.

As many as 81 percent of doctors reported that they are either working at full capacity or extended beyond their capacity. In addition, 44 percent of the doctors surveyed are considering cutting back on the number of patients they see in a month. Some doctors even talked about closing their doors to new patients, working part time or retiring altogether. The survey definitely reveals the additional pressure mounted on physicians with newly insured looking to find doctors.

Health plans, on the other hand, are more concerned about the rising competition in this new market, prompting them to cut the number of doctors in networks to curtail costs. This creates a roadblock of sorts for patients who are faced with either waiting for an extended period of time to get an appointment or incur additional out of pocket costs by seeing a doctor that is outside of the network.

With this primary care doctor shortage, the Obama Administration’s original purpose of connecting the uninsured to affordable, fully covered primary care is falling short. Nearly 20 percent of Americans are living in an area with a shortage of primary care physicians, and the supply of doctors isn’t enough to meet the demand. This supply-demand gap is expected to increase further, with nearly 66,000 additional doctors needed to fill this gap by 2016. Another major reason for this gap is that medical students are moving toward higher paying specialty areas instead of the primary care. Fortunately, until now, patients are receiving the care they need by driving farther out of their area, spending more time waiting for care, or settling for a nurse practitioner or an assistant instead of the doctor.

Naturally, this perennial challenge needs a resounding, permanent answer that can curtail this widening gap in primary care doctor supply-demand. One way is to ensure that more primary care physicians are available for the masses. The American Academy of Family Physicians has more than 115,000 member doctors, and it is constantly working to add new physicians, train nurse practitioners and assistants, and expanding their schedules by accepting patients in evening and weekends. Also, patients can utilize the second open enrollment to look for better health plans that give them a shot at easier access to doctors.

On November 7, when the United States Supreme Court decided that it will hear the King v. Burwell case, the nation collectively gasped at the ramifications this hearing will bring to the reformed health market. [Side note: The Court will hear arguments on March 4, 2015] According to the King v. Burwell case, the Affordable Care Act’s language does not allow federal tax credits to be provided to people who bought health insurance from the federally facilitated marketplace. The 4.5 million people who bought insurance in 34 states, which utilized the federal exchange for their insurance needs are at the risk of losing the tax credits that connect these people to affordable health insurance.  However, that is not the only problem connected with this Supreme Court hearing.

Assuming that the United States Supreme Court decides that the federal exchange is not eligible to provide subsidies to people with insurance in those 34 states, what happens next? Logically, considering the amount of subsidies available to the states and people, most states will make a rush to have their health insurance exchange up and running before the Supreme Court ruling comes into effect. The general consensus is that the Court ruling will be announced in June/July timeframe. To support this movement from all these states, the HHS might allow some relaxation in rules about the establishment of the exchanges. By the time the Supreme Court passes this ruling, the states will still be a little late for meeting the 6.5 month conditional approval requirement before state exchange launch. Agreed, the HHS might relax these deadlines a bit, but it would still mean a lot of overhead for these states.

While considering that, let’s not forget that some of these states could not get their health insurance exchange up and running in the years they had before the rollout of ACA. Another more probable case would be states beginning their health exchange establishment plans, which could take somewhere around 6 months. What happens in these 6 months? Complete chaos. When the subsidies are dropped, some of the people with health insurance might not be able to pay their health insurance premiums. Due to nonpayment of premiums, most of them will stand to lose their health insurance in 30 days at the most. The health insurance plans will lose these customers and the subsequent market share. The people who retain their health insurance post this would be the ones who most need the health insurance. Naturally, with sicker, unhealthier people in the pools, health plans will run the risk of higher losses and lower profitability in the market. In an already competitive market, not every health plan will be able to bear the brunt of this onslaught, and some of them might succumb, leading to a destabilization of the insurance market. It will be likely the lose of subsidies will not immediate as that will render the market unstable.

Other than these, there is another parallel thread running along. It’s not yet certain whether a state with an outer shell that utilizes the functionality of healthcare.gov internally qualifies as a state established exchange, and the HHS plans to make use of this. In 7 states, the HHS is planning to recognize the partnership exchanges, exchanges which are managed by the State but run jointly with the federal government, as state-based exchanges that are eligible for providing tax credits to enrollees. However this partnership would only makes really help the 7 states, the remaining 27 states are still nonplussed about how to proceed.

And then there is the case of ‘state innovation waivers’. Under these waivers, if a state offers similar, affordable coverage under an alternate plan, they are allowed to circumvent a few primary ACA requirements, such as having an exchange or offering premium tax credits, without losing the federal funding they are eligible for under the ACA. However, the concept of waivers does not kick in before 2017, and until then, the residents of these states will be in a coverage gap without any premium tax credits for residents, assuming that the challengers win the case.

Ultimately, amid all these threads and ideas, the Obama administration, the health plans, and the state authorities are in a state of clamor without any certainty of their future. In case the challengers in King v. Burwell win, it could mean a whole lot of consequential changes for Obamacare that could ultimately rob it of its potency.  It is definitely going to be interesting to watch!

When Florida indicated it was in agreement with Obamacare on expanding Medicaid for its residents at the beginning of 2013, low income Floridians heaved a sigh of relief. This expansion under the Affordable Care Act was to be their shot at better, affordable health care in a state where high unemployment and poverty rates were very high. However, by the end of 2014, Florida is still not ready with the Medicaid expansion after nearly two years of siding with the program

Through a decision was made by Governor Rick Scott and the state accepted federal funds by agreeing to expand Medicaid for low income Floridians, the state has not gone through with the actions, leaving the federal funding out of reach of the taxpayers. Ultimately, Florida decided not to expand Medicaid, leaving its people stranded in the Obamacare coverage gap.

Now, since Florida has no plans to expand Medicaid, low income adults of the state are earning too little to qualify for premium tax credits under the Affordable Care Act. In states that expanded Medicaid the situation of these young adults would have been much better. For example, in California, a low earning young individual with an annual income of $12,000 would only be required to pay $20 per month for health insurance premiums. If the annual income is less than $11,000, the health insurance coverage is free of cost. In these where Medicaid is expanding, both the cost cutting facets of ACA are being put to use. People are either earning enough to qualify for premium tax credits that cut down their health insurance premiums to nominal price, or earning so little that they fall under the net of expanded Medicaid.

Without the Medicaid expansion in Florida, nearly 1 million people do not have access to better health coverage. Out of these 1 million, a little more than 33 percent are young adults with insufficient annual earnings. As many as 25 percent of young Floridians in the age group of 18 to 34 live in poverty, and for a state without Medicaid, the situation is naturally bad. Rising education costs and falling employment rates are some other troubles that are hounding this age group, ultimately causing them to be unfit and being the second most common age group that uses the emergency room, after the seniors.

With young, uninsured Floridians struggling with employment, income, and health insurance, the state administration definitely needs find a solution. Fortunately, the state administration admits that the coverage gap is a pain for Floridians and the state is ready to make some amends to close this gap as soon as possible. The state might actually take a leaf from Arkansas’ book and deliver a better solution. Instead of using the help of public programs, the state might use the available federal funding to pay for private health insurance that can cover some of these low-income young individuals. These private plans could provide these individuals with much needed coverage without turning into a liability on public programs, a facet that could satisfy conservatives and liberals both.

In any case, Florida’s leadership needs to move quickly. After the recent elections, the new legislative session will see a renewed debate on the health coverage gap, and if Governor Rick Scott prepares in advance, he could save a lot of time and energy of the session by providing them with a viable plan that can satisfy both the parties. Without an extended, contentious debate, the leadership can affect a closure of the health coverage gap for these young, uninsured individuals who are struggling to make ends meet.

As the first segment of the second enrollment draws to a close, a lot of people are asking the standard question – what happens to me if I don’t have health insurance throughout 2014? Most people know that the individual mandate requires them to have health insurance in 2014, failing which they will be subject to tax penalties, but not everyone knows how much those penalties will cost. Contrary to what people believe, Obamacare penalties are not going to be tlight for families, and they are set to triple in the next financial year. So if you still don’t have health insurance, let’s see how Obamacare penalties can affect you at tax filing this year. Read more