Florida led nation in new ACA signups this year. Biden directs market to open again.

Florida, a state that has led in new sign-ups for health insurance coverage under the Affordable Care Act since its creation, saw a nearly 9% increase in new sign-ups since the coronavirus began. President Joe Biden’s announcement Thursday that he’ll open a special enrollment period for uninsured Americans to obtain health coverage is likely to push numbers even higher.

Biden’s executive order directs the Department of Health and Human Services to open HealthCare.gov for insurance enrollment through the program, also known as Obamacare, from Feb. 15 through May 15.

“The best way to describe it is to undo the damage Trump has done,” Biden said during brief remarks in the Oval Office before he signed the order. “As we continue to battle COVID-19, it’s even more critical that Americans have meaningful access to healthcare.”

In most states, including Florida, the open enrollment period for 2021 coverage — which the Trump administration halved from 12 to six weeks — ended Dec. 15.

Insurance obtained during the new enrollment period will become effective based on the sign-up date. Sign up before March 15, and the insurance will go into effect April 1. If it’s before April 15, insurance is effective May 1. Sign-ups before May 15 will become effective June 1.

In a pandemic year when health insurance is more important than ever, 525,509 Floridians signed up for the first time. At the end of the ACA open enrollment period Dec. 15, a total of 2.1 million Floridians had signed up to obtain health insurance through Obamacare, according to data released by the Centers for Medicare and Medicaid Services, or CMS. Even more are expected to enroll in 2021.

Florida is part of the federal Obamacare insurance marketplace. Some states, like California and New York, have state-based marketplaces. And Florida was the top state in 2020 for the number of people enrolled in plans, topping states like Texas with 1.2 million.

“[The pandemic] certainly has had an effect on those numbers,” said Jodi Ray, executive director of Florida Covering Kids & Families, a navigator program based at the University of South Florida. Healthcare “navigators” help consumers find the best plan for them.

Last year, despite lobbying from the healthcare industry and elected officials from both parties, then-President Donald Trump refused to open a special enrollment period aimed at helping those who lost work-based insurance due to the pandemic. Eleven states that run their own Obamacare marketplaces allowed uninsured residents to sign up in the early weeks of the pandemic.

The pandemic has forced more than a million Floridians out of work, causing many to lose health insurance provided by their employers. As a result, Ray’s office has seen lots of renewals of plans, but also an unprecedented number of first-time enrollees who lost work in industries such as the performing arts or tourism.

The state’s reliance on tourism-related workers who were out of jobs for large portions of 2020 — in places like theme parks and cruise ship destinations, for example — has created extra problems for Florida that Ray expects will continue for at least the next year.

Reopening the marketplace for Americans does not come as a surprise to Ray, who said these conversations had been happening on a national level for a couple months now.

“I know we are going to be right back where we were when this starts up again,” she said. “Florida is unique in that demand continues to not only remain high, but continues to grow.”

Biden had pledged during his campaign for president that he would protect the ACA and build on it.

In addition to opening a special enrollment period, the president is also likely to direct federal agencies to reconsider some rules and policies in an effort to protect and strengthen access to healthcare, including policies that undermine protections for people with pre-existing conditions.

Outreach needed

Ray said she hopes to see a strong push on communication and marketing to ensure people are aware of the enrollment period. Since 2016, there were substantial Trump administration cuts to funding for ACA marketing and outreach activities.

“They need to have a plan to let people know about this. If you open enrollment in a vacuum, it’s useless,” Ray said. “[Funding] has been decimated over the last four years. They need to find a way to support the resources on the ground to manage that.”

Even with the cuts to outreach efforts, Florida has still led the nation in enrollment, proving “there’s truly a need,” according to Rep. Nicholas X. Duran, a Miami Democrat who served as the Enroll America state director from 2013 to 2015.

In one ZIP code, 33178, which covers two communities west of Miami, Doral and Medley, more people have selected a plan on the Affordable Care Act insurance exchange than most places in the country, with more than 20,000 enrolled. Hialeah ZIP code, 33012, falls closely behind with 17,000 enrolled.

Duran attributes Florida’s high enrollment to several things, including people who move to Florida, qualifying them for Obamacare enrollment as a life-changing event. The loss of work during the pandemic also qualifies as a life-changing event, and so does securing a new job.

“We rely heavily on the marketplace here, even without the kind of outreach that should come with it,” said Duran.

McClatchy DC reporter Michael Wilner contributed to this report.