Health Care

As deadline looms for 2019 Obamacare coverage, Florida leads nation in sign-ups

In this 2015 file photo, a man in a Statue of Liberty costume advertises Affordable Care Act coverage in Little Havana. The deadline to sign up for 2019 coverage is midnight Dec. 15. Eligible consumers can sign up online at healthcare.gov or by calling 800-318-2596.
In this 2015 file photo, a man in a Statue of Liberty costume advertises Affordable Care Act coverage in Little Havana. The deadline to sign up for 2019 coverage is midnight Dec. 15. Eligible consumers can sign up online at healthcare.gov or by calling 800-318-2596.

With the midnight Dec. 15 deadline fast approaching for eligible consumers to sign up for 2019 Affordable Care Act coverage through the federal health insurance exchange at healthcare.gov, enrollment across the country is lagging compared to prior years.

But Florida, which consistently has led all states in the number of residents who choose ACA coverage, also known as Obamacare, is not far behind last year’s totals.

Through Dec. 8, 999,045 Floridians had selected an ACA plan, according to enrollment data from the Centers for Medicare and Medicaid Services, the federal healthcare regulator that runs healthcare.gov. During last year’s open enrollment for ACA coverage, 1.02 million Floridians had signed up for coverage at the same point in the sign-up period — a difference of more than 22,000 consumers or about 2.2 percent.

A total of 1.7 million Floridians signed up for an ACA plan during last year’s open enrollment period.

Nationally, more than 4.1 million consumers have selected a plan for 2019 coverage in the 39 states, including Florida, that use healthcare.gov. Of these consumers, about 1.1 million are new customers and 3 million are renewing coverage.

Enrollment is lagging this year despite a stable market for ACA insurers that includes more companies offering coverage and low premiums for many consumers who qualify for financial aid to make their coverage affordable.

It’s not clear why enrollment on the federal exchange so far is lagging. About 545,000 more consumers had signed up for an ACA plan through nearly the same period last year. In contrast, most of the 11 states, plus Washington, D.C., with their own insurance marketplaces are reporting increased enrollment over last year.

Among the factors that may be impacting sign-ups on healthcare.gov are the low unemployment rate, the repeal of the individual mandate that imposes a financial penalty on those who do not have coverage, a significant reduction in marketing and outreach for in-person assistance, and other events specific to individual states — such as Virginia’s newly expanded Medicaid program.

In addition, new federal rules allowing consumers to buy coverage that does not comply with the ACA, such as short-term, limited-duration plans and association health plans, may be siphoning consumers away from Obamacare. However, short-term plans use medical underwriting, which allows those insurers to deny coverage to people with pre-existing medical conditions, and typically do not offer benefits as comprehensive as those mandated under Obamacare.

Still, it’s not clear why so many Americans who are eligible for financial aid to buy an ACA plan are passing up what may amount to free coverage.

A recent analysis by the nonprofit healthcare think tank, Kaiser Family Foundation, estimated that about 4.2 million uninsured Americans, including about 623,000 Floridians, could get the lowest level of coverage, also known as a bronze plan, for 2019 and pay nothing in monthly premiums after factoring in financial aid.

However, bronze plans typically leave consumers exposed to high out-of-pocket costs, including deductibles and co-insurance. But they do protect consumers from financial ruin due to medical expenses because all ACA plans have an out-of-pocket limit and prevent insurers from imposing lifetime caps on spending per consumer.

As open enrollment winds down, some health insurers are reporting brisk business. Douglas Bartel, a spokesman for Florida Blue, the state’s largest health insurer, said in an email that agents and phone sales teams have been “quite busy.”

“Through consumers and our agent-assisted transactions, we are not hearing about or experiencing issues with healthcare.gov,” Bartel said. “So, people seem to be interested in ensuring health plan coverage for 2019.”

In addition, CMS, the federal healthcare regulator, indicated in a statement this week that consumers are waiting until the last minute to sign up.

“As in past years, we have seen an uptick in the volume of consumers using HealthCare.gov and contacting our call center as we get closer to the December 15 deadline to select a plan for the upcoming year,” a CMS spokesperson said in an email.

As more consumers call to apply for ACA coverage, many may be asked to leave their contact information and those individuals will be allowed to enroll in a plan after the deadline. Consumers asked to leave their contact information with the call center will be contacted after Dec 15 to complete their applications and plan selections.

Consumers who wish to apply for an ACA plan can call 800-318-2596 or 800-706-7893 or visit healthcare.gov by midnight Dec. 15.

Daniel Chang covers health care for the Miami Herald, where he works to untangle the often irrational world of health insurance, hospitals and health policy for readers.

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