Open enrollment begins Tuesday for the Affordable Care Act insurance exchange at healthcare.gov, with consumers facing higher premiums, fewer choices of health plans and a measure of uncertainty about the future of the health law better known as Obamacare.
In Miami-Dade and Broward counties, where nearly 650,000 people signed up for an ACA plan in 2016 — more than any other metropolitan area in the nation — consumers will have fewer choices of insurers but an equal or greater number of health plans for 2017 than the current year.
At least 61 plans are available in Miami-Dade and 60 in Broward, with full-price monthly premiums ranging from less than $300 to nearly $1,000, depending on a consumer’s age, smoking status and county of residence.
To be eligible for the premium tax credit, a Florida applicant’s annual household income must be at least 100 percent of the federal poverty line, or $11,670 for an individual, and $23,850 for a family of four in 2015.
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While those premiums reflect an average 19 percent increase for ACA plans sold in Florida for 2017, according to an analysis by the state’s Office of Insurance Regulation, most consumers who buy their coverage on healthcare.gov will not feel the pinch, said Karen Egozi, chief executive of the nonprofit Epilepsy Foundation of Florida, which will provide in-person counseling statewide.
“Although the prices have gone up and the premiums have increased, so have the subsidies,” Egozi said, referring to the tax credits and discounts that eligible consumers receive to make their ACA plans more affordable. “So, it isn’t like a major increase.”
Of the 1.5 million Floridians who signed up for an ACA plan in 2016, nine out of 10 received a subsidy that lowered their monthly premiums, according to the U.S. Department of Health and Human Services. And many Floridians on the ACA exchange, about 86 percent, qualified for the most generous benefits, which help them pay for premiums and out-of-pocket expenses, such as deductibles and co-payments.
Yet even with Florida’s high enrollment in healthcare.gov, many more residents are unaware they are eligible for subsidized coverage, according to estimates from the Obama administration, which has selected the Miami-Fort Lauderdale area for extra outreach.
According to the estimates, Florida is home to about 153,000 people who buy individual health insurance without using the ACA exchange, even though their incomes would qualify them for subsidies to make ACA coverage more affordable.
19% Average premium increase for plans sold in Florida on Affordable Care Act exchange for 2017
To help reach those individuals and re-enroll existing consumers, HHS will partner with nonprofits such as the Epilepsy Foundation and local Health Councils that help coordinate health planning across the state, to canvas neighborhoods with high rates of uninsured resident and to promote sign-ups at college and university campuses.
“What we’re trying to do this time is really get a lot of boots on the ground,” said Monica Gonzalez, who manages the navigator enrollment counseling program for Epilepsy Foundation. “We’re going to neighborhoods and going door to door, meeting people while they’re out on their lunch break and having conversations.”
Navigators with the Epilepsy Foundation also have forged partnerships with consulates in Miami-Dade to reach newly arrived immigrants, said Juanita Mainster, an enrollment counselor.
“One of our initiatives,” Mainster said, “was to work and develop partnerships specifically with the Latin American consulates in Miami, and bring them in to educate those populations that they serve. ... We’re not only reaching that particular person who’s there but the entire extended family of the individual who’s there. That puts the word out to the community.”
Egozi said navigators always counsel re-enrolling consumers to check their plan before renewing it, even if they intend to keep the same one, because coverage benefits may have changed from the prior year.
“They still need to look and compare the coverage, compare the premiums, and look what doctors and physicians are on it,” she said.
Consumers must sign up for a plan by Dec. 15 in order for coverage to begin on Jan. 1, but the open enrollment season runs through January.
A list of ACA exchange enrollment counselors in South Florida is available at localhelp.healthcare.gov.