TAMPA — As a retired nurse, Anita Balch expects friends and neighbors to ask her for straight answers on health-related questions.
Lately, though, she's grown irritated. Not with their queries, but with a lack of straight talk regarding the nation's new health care law. Her frustration recently led to an hour-plus drive from her Auburndale home to a Democratic Party-leaning news conference at a Tampa hotel, where she hoped to get answers.
Exasperated, Balch told the room of politicians, activists and journalists that the five-year-long divisive debate over the Affordable Care Act — aka Obamacare — has only confused the people the law directly affects. She's fed up.
“You guys, the average American deserves to get information,” she said at the news conference, which was designed to counter a conservative Republican rally later that day. “I don't need the polarization. ... I want every human being to get the truth.”
A looming milestone compounds Balch's irritation. Three months from now, on Jan. 1, the most significant and controversial part of the law goes into effect: a requirement that all Americans have health insurance.
Balch says she and her neighbors can't sort out facts from political fiction and do what they need to be ready.
“I want more specifics,” she pleaded.
Balch's uncertainty isn't unique: a Kaiser Family Foundation survey revealed that more than half the country still doesn't understand how the Affordable Care Act directly affects them. And more than 40 percent think the law, passed in 2010, has been overturned, or they are unsure of its status, according to the survey taken in mid-August.
It's no wonder, given that for the past five years the 2,000-page overhaul of the American health care system has been unceasingly debated in Washington, D.C., and all 50 state capitals, and has undergone the ultimate judicial scrutiny before the U.S. Supreme Court in 2012.
Today, much of the law remains intact. And major portions that directly affect millions of Americans will go into effect in the coming months. Specifically, the about 25 percent of Floridians who don't have health insurance or those who buy individual plans (not through an employer) will be able to shop for health coverage online starting Oct. 1 so they can comply with the mandate.
That's right: about 25 percent.
The U.S. Department of Health and Human Services and some private groups are spending hundreds of millions of dollars to promote Healthcare.gov, an “exchange” or marketplace to offer subsidies to poor and middle-class Americans. In Florida, where the federal government is running the program, the main targets are the state's nearly 4 million uninsured residents.
This push for enrollees, coupled with the political rancor, implies that all Americans need to line up for the marketplace or face a financial penalty. But people with employer-based insurance, seniors with Medicare or individuals on Medicaid can't apply. They already have insurance and, therefore, already comply with the Jan. 1 coverage deadline.
“I do not feel it has been clear to me or my husband, and we wonder just how much it affects us,” said Sandra Smith, a Sebring retiree who has been on Medicare and a supplemental insurance plan for nearly a decade.
Smith, 74, and her husband, George, 76, began asking questions when they read emails forwarded from family and friends about the health care law. It's been years since they sat down with an insurance agent, so the mixed messages they've seen online and in the media made them apprehensive, she said.
Seniors are not the only ones with false impressions about the Affordable Care Act, said Justin Treece, an employer-plan benefits advisor at Connelly, Carlisle, Fields & Nichols, a Tampa-area insurance agency.
“There is a misconception that people are eligible for free health care,” Treece said.
Instead, the law places limits on how much people have to pay for coverage, depending on income, work status and other factors. Under the law, subsidies and tax credits will be calculated for people eligible for and applying on the online marketplace.
Another politicized twist involving Florida's highly subsidized health coverage for the state's poor children, pregnant women and the disabled confuses the public's understanding of the Affordable Care Act even more.
Florida's Legislature this spring opted to not participate in the law's expansion of Medicaid, which would have added nearly 1 million poor adults in the state to the program.
Employers large and small face new requirements for what they offer workers and how much they contribute to coverage. For example, those with insurance through an employer can no longer be charged more than 9.5 percent of their income for coverage, or the business will be penalized.
That's why workers could see tweaks and changes to monthly costs come annual enrollment time. However, the basics of many plans remain unaffected by the law.
Stephen Parks, a primary care physician in Brandon for more than 30 years, said he can't go a day without a patient asking him to clarify what the law means. These aren't just the uninsured; nearly all of his patients have Medicare or commercial health insurance.
Parks said all the talk about health care reform has only produced more questions for his patients, and a lot of other Americans, insured, uninsured and those who aren't so sure.
“Nobody knows what it's about,” he said “… Every day, one of them will ask: 'What's going to happen to me?'”