More Floridians turn to Obamacare as pandemic deepens

Obamacare is more popular than ever in Florida.

Signups by Florida consumers for Affordable Care Act health care plans increased by 7% during the first three weeks of open enrollment compared to last year, federal figures show.

Experts say more enrollees are likely turning to the health care marketplace because they lost their jobs and with them their employer-based health insurance during the COVID-19 pandemic. About 93% of ACA enrollees in Florida qualify for tax credits to help low-income consumers pay for coverage.

Others are enrolling earlier because they’ve heard that the U.S. Supreme Court might strike down the law that created the insurance marketplace and, along with it, requirements to cover preexisting conditions and provide tax credits.

Cliff Eserman, a Wilton Manors-based health insurance broker, said 30% of his current customers are first-time ACA enrollees.

“Some feared a Trump reelection or that the Supreme Court would strike down the law. There was a sense that they could be grandfathered in if they enrolled now. So they thought they’d get ahead of the game,” Eserman said.

Some clients who experienced job losses or sharp drops in their income decided to lock in their coverage early out of fear a COVID-19 infection could result in costly hospitalization, Eserman said.

With 10 competing insurance networks to choose from — up from six a couple years ago — clients are spending more time choosing a plan that won’t break them financially if they contract the virus and require hospitalization, he said.

Florida Blue, the state’s dominant health insurance company, said it responded to increased competition by developing new low-cost plans. “We’re seeing individuals opt for our new plans as opposed to keeping their existing plans. This, we believe, is a partial driver of the higher volume,” Nick Tant, the company’s vice president for individual and small group plans, said in an email.

While unemployment rates have improved sharply in Florida since hitting 12.9% in April during the pandemic-driven recession, 659,000 workers remained without jobs in October, largely because infection-wary consumers continue to stay away from hotels, restaurants and tourist attractions, state labor figures show.

Jodi Ray, who oversees statewide enrollment outreach efforts at the University of Florida’s nonprofit Florida Covering Kids & Families program, said she’s seeing a lot of Floridians who lost their jobs during the pandemic enroll in ACA plans for the first time.

She’s also seeing consumers signing up in Florida after relocating from high-wage states such as California and New York and taking lower-paying jobs here that don’t offer health insurance.

“This is the busiest I’ve ever been — even busier than when open enrollment first opened” in 2013, she said. Enrollees who need help navigating the HealthCare.gov signup portal can schedule an appointment by going to CoveringFlorida.org, she said.

Prospects of a vaccine have raised expectations in Florida and across the nation that the economy will eventually return to normal. But in the meantime, workers who have seen their incomes fall and expect to earn significantly less money in 2021 are qualifying for health care plans with generous tax credits.

Consumers who would otherwise have paid an average $597 a month if they didn’t qualify for assistance received tax credits worth $533 a month in 2020. That left their out-of-pocket monthly premium cost at $65. Individuals can qualify for tax credits by earning between $12,760 and $51,040 a year. The lower their income is, the more they receive in tax credits, and ACA regulations allow consumers to price their plans according to how much income they project they will make during the upcoming year.

If they end up earning more than projected, they should revise their projections during the year so their tax credits can be adjusted, Eserman said.

Meanwhile, 8.3 million consumers nationwide, including 1.9 million in Florida and about 800,000 in South Florida, await the result of another effort by Republican lawmakers to kill the Affordable Care Act, which was enacted under the Obama administration a decade ago.

The U.S. Supreme Court recently heard arguments in a case that seeks to invalidate the entire ACA, and along with it, its tax credits and preexisting condition coverage requirements.

Most experts don’t believe the court will take such a drastic step, based on comments by several justices during oral arguments in the case on Nov. 10, says Cynthia Cox, a health insurance policy expert for the nonprofit Kaiser Family Foundation.

“But it’s hard to predict what the Supreme Court will do. They’ve thrown some curve balls regarding the ACA,” she said.

If the Supreme Court invalidates the law, experts expect it would allow tax credits to continue until 2021 plans currently being sold expire at the end of next year, Cox said.

But the court could also invalidate the Affordable Care Act and immediately cut off the tax credits that keep coverage affordable. If that happens, insurers will tell consumers now paying an average $65 a month that they’ll have to come up with the full $597 or lose their coverage. That would be unaffordable for most who rely on the ACA, she said.

Since the marketplace was created in 2013, Florida has consistently led enrollee counts among the 36 states that rely on the federal government’s HealthCare.gov platform.

Last year, 1.9 million Florida consumers signed up during the open enrollment period for 2020 coverage that ran from Nov. 1 to Dec. 18. That was 7% more than the previous year’s 1.7 million signups. Florida Blue’s Tant said the company expects nearly 2 million Florida consumers will enroll in a 2021 ACA plan.

So far between Nov. 1 and Nov. 21 of this year, 706,686 consumers signed up for marketplace coverage, compared to 658,453 who signed up between Nov. 1 and Nov. 23 of last year. Most signups are by consumers who have coverage this year and are renewing or selecting competing plans for 2021. Federal data does not yet include state-level breakdowns of new and renewing enrollees.

Open enrollment lasts six weeks, ending on Dec. 15. But consumers can enroll throughout the year if they undergo a life-changing situation, including marriage, divorce, legal separation, having or adopting a baby, moving to a new ZIP code or county, or losing existing health insurance, among other circumstances.

A year ago, Kaiser Family Foundation published a report stating that nearly 700,000 Florida residents are eligible for free, high deductible ACA plans that would provide free preventative care, including yearly checkups, blood work and screenings, but they don’t sign up.

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