Open enrollment is here for the Affordable Care Act, and though premiums have gone up slightly, experts once again expect record enrollment in Florida.
The coronavirus pandemic has forced more than a million of the state’s residents out of work, causing many to lose health insurance provided through their employer. That means more are turning to the federal marketplace for coverage.
Because of the virus, the health care “navigators” who help consumers find the best plan for them are doing much of their work virtually. That comes with pros, like more flexibility with appointments, but also cons for those without technology or a high level of understanding about health insurance.
At the same time, consumers worry about the future of the Affordable Care Act, commonly known as Obamacare, as it is threatened once again in a Supreme Court case. But experts say enrollees should focus on the here and now.
“It’s still the law of the land,” said Cynthia Cox, vice president of health nonprofit Kaiser Family Foundation who does economic and policy research on the Affordable Care Act.
“This court case doesn’t change what’s available to you right now," she added." You have to make your health insurance decisions based on that, not what might happen in the future."
What’s new this year
There are 120 plans available this year in Tampa Bay, compared to 77 last year, said Melanie Hall, executive director of the region’s Family Health Care Foundation, which helps people sign up on the federal exchange.
Every insurance provider offering plans in Florida will have at least one that comes with a zero-dollar deductible, she added, but cautioned that those plans can come with a high out-of-pocket maximum.
“It’s very important that when people are considering those plans that they go into the summary of benefits,” Hall said. “What’s not obvious is those plans have separate pharmacy deductibles and high co-payments."
Premiums in Florida are going up about 3 percent on average, though the exact amount varies by region, Hall added. But the increases will mostly affect about 10 percent of consumers who don’t receive the tax credits that make their insurance more affordable.
More plans offer health savings accounts, which let consumers set aside money pre-tax for certain medical expenses. Those will be more attractive to those who aren’t getting tax credits and will pay full price for coverage, Ray said.
It’s important that enrollees look at new options and don’t auto-enroll in the same plan they had this year, Cox said. There may be options that are cheaper or better fits.
About 1.9 million Floridians signed up for Obamacare this year, and even more are expected to enroll in 2021, said Jodi Ray, executive director of Florida Covering Kids & Families, a navigator program based at the University of South Florida.
How COVID-19 impacts enrollment
With so many more people unemployed because of the pandemic, more people are looking to the marketplace for health insurance. They might not have much experience with it, if they have any at all.
Ray has seen the toll on those seeking help at USF.
“It’s just been hard on people,” she said. “Trying to navigate getting their family health insurance is overwhelming on top of what they’re dealing with to stay afloat, make sure they can bring food home and keep the electric on. ... There’s such a high level of uncertainty going on."
At the same time, outreach by Ray and other navigators has also been strained by the pandemic. In-person events are few and far between these days, so they’ve been trying to connect with people online and over the phone. That’s harder in rural and impoverished areas, she said.
“For some people, virtual and phone appointments don’t work,” Ray said. “Try talking to someone over the phone about 77 plans, especially if they don’t have a high level of health insurance literacy."
So the USF navigator program has been working to get its office ready for in-person appointments that aim to keep consumers safe from the coronavirus. There are plexiglass, reminders to social distance, free masks and separate containers for pens that are clean and used.
There will be limited face-to-face appointments available at the Family Health Care Foundation, too, Hall said. Luckily, the center started offering virtual appointments last year, so it was ready to expand them in the pandemic.
She said most consumers the foundation helps prefer virtual assistance. And it helps navigators be more flexible in that they can offer weekend and evening appointments that are more convenient for enrollees.
“We are not limited in when and where we can see people,” Hall said. “I think we are more available than we’ve been in the past."
The future of the Affordable Care Act
The Affordable Care Act has been swirling through the news recently as Amy Coney Barrett was confirmed to the Supreme Court. With her fellow justices, she will soon weigh in on the future of the health care law that covers 20 million Americans, and many worry it could be dismantled.
Hall’s office has gotten lots of calls from consumers with those fears, she said. But no one knows what will happen, and that shouldn’t affect enrollees' choices anyway.
“The program has been challenged at all levels, and it has survived,” she said. “Ultimately, it remains the law of the land, and as long as it is, we will be here to help people through the enrollment process."
If the Supreme Court does rule to overturn the law, more decisions would have to be made by Congress about what happens next, Ray said. And those who are ensured through the program will still have valid contracts with their chosen insurance providers.
“We are focused on the here and now,” she said. “And right now, getting covered for 2021 is possible."
Open enrollment: What you need to know
- The period is from Nov. 1 to Dec. 15.
- Even if you’ve already enrolled in a marketplace plan, it’s important to update personal information to ensure the best tax credit and premium prices.
- Covering Florida will have some in-person appointments this year, plus virtual and phone assistance. Call 877-813-9115 or visit coveringflorida.org to sign up.
- The Family Healthcare Foundation will have very limited face-to-face appointments this year. To set up a virtual or phone appointment, call 877-813-9115 or 813-995-1066. Appointments can be scheduled online at Familyhealthcarefdn.org/enroll. Services provided in English, Spanish, Creole and Portuguese.
- Questions about the Affordable Care Act? Check out the FAQ section on the Kaiser Family Foundation’s website.