The vast majority of Floridians who signed up for healthcare coverage under the Affordable Care Act this year received financial assistance — the second highest rate of financial help in the nation, according to federal data released Tuesday.
The numbers were released from the U.S. Department of Health and Human Services just as the legality of the financial help, which comes in the form of tax credits, is being tested in the courts. The U.S. Supreme Court heard arguments March 4 in a case challenging tax credits under the provisions of the ACA.
About 93 percent of the nearly 1.6 million Floridians who signed up for health insurance on the federally-facilitated marketplace during the enrollment period that ran from Nov. 15 to Feb. 15 received a tax credit to lower the cost of their monthly premium. In 2014, 91 percent of Florida consumers had financial help.
Only Mississippi ranked higher, with 94 percent of enrollees receiving a tax credit.
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“The figures released today tell a story of health coverage consumers rely on for financial and health security — and of coverage they don’t want to lose,” said HHS Secretary Sylvia M. Burwell, in a press release.
Before financial assistance, the average monthly premium in Florida was $376. The average tax credit awarded was $294. That means the average monthly premium in Florida was only $82.
Just two states — Mississippi with $52 and Georgia with $73 — have lower average monthly payments.
Nick Duran, Florida state director for Enroll America, a nonprofit that advocates for people to gain coverage, said that while educating consumers about their access to financial assistance, many began to reexamine their healthcare options.
“We have seen the need and the access to financial assistance is a big interest and a big conversation starter,” Duran said. “Folks went out and took advantage of that opportunity to do so.”
The Tuesday report offered little information on minority enrollment. It is not required to specify race or ethnicity when signing up for coverage, and about 37 percent of people elected not to, said Meena Seshamani, director of the office of health reform at HHS.
Nationally, of those who did list race and ethnicity, 11 percent were Latino, 14 percent were African American and 65 percent were white.
In total, 11.7 million consumers signed up for coverage on either a state or federally-facilitated marketplace across the country. About 87 percent who enrolled though HealthCare.gov received a tax credit.
Florida, the national leader in sign ups, reenrolled 45 percent of its consumers. About 55 percent were new enrollees.
Of those who reenrolled, 41 percent switched plans from last year, a figure that federal officials said revealed greater consumer engagement with the marketplace.
“Marketplace consumers took charge of their healthcare and that sends an important signal to insurers,” said Kevin Griffis, acting assistant secretary for public affairs at HHS. “It is not enough to simply be in the marketplace. If you want to win in business, it’s critical to compete on price.”
Griffis said that nationally, there were 25 percent more insurers in the marketplace this year. Still, the average premium in Florida went up slightly from $68 last year.
Ron Pollack, executive director of Families USA, the national organization for healthcare consumers, said that fluctuation is not surprising.
“The fact that this has been an enormous success in Florida means that more insurance companies will be encouraged to offer plans in this marketplace,” Pollack said. “That helps to put downward pressure on premium costs.”
The importance of the tax credits to lower premiums will come to a head in June, when the Supreme Court is expected to make a decision in King v. Burwell, the case which challenges specific wording in the ACA that says tax credits will only be available to consumers who purchase coverage in exchanges “established by the state” — not the federal government.
In Florida, which has a federally-run exchange, about 1.48 million people would likely stand to lose their tax credits.
Last week, Families USA sent several Floridians to Washington, D.C., to tell their stories about the importance of their tax subsidies on the steps of the court as oral arguments for the case began.
“If the opponents of the ACA prevail in court, it will mean that huge numbers of people will have their subsidies withdrawn and they will probably rejoin the ranks of the uninsured,” Pollack said. “The stakes, with respects to the court decision, could not be higher.”
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This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation