Florida enrollment in Affordable Care Act surpasses 3 million

Florida once again leads the nation in enrollment for health insurance through the Affordable Care Act.

A record 3.2 million Floridians signed up for health insurance plans for 2023 offered through the federal marketplaces, according to data released Wednesday by the Centers for Medicare & Medicaid Services. That’s roughly 500,000 more than last year and almost a million more than the next highest state, Texas.

Nationwide, the federal program, which was signed into law by President Barack Obama in 2010, is more popular than ever, with a record 16.3 million Americans enrolling. That includes 3.6 million new members.

The federal government’s decision to make premium subsidies available to more people during the pandemic has been credited with driving up enrollment. The subsidies, established in the American Rescue Plan, were extended to the end of 2025. For families with an income above the federal poverty level, it can mean insurance is free or their premiums are as low as $10 per month.

“We will see a decrease in the insured rate,” said Jodi Ray, project director of Florida Covering Kids & Families, a navigator program based at the University of South Florida. “I feel good we’ve been able to make even more people aware of getting affordable access to health care.”

Ray said there is still much work to be done. Florida still has a higher-than-average uninsured rate, and access to health care in rural areas is still spotty, she said.

And Florida’s failure to expand its Medicaid program means an estimated 400,000 people remain in the so-called coverage gap since they earn too much to meet Florida’s strict criteria, even though they earn below the federal poverty level.

“This is the mistake made when the Affordable Care Act was passed — this idea we can wash our hands,” Ray said. “We’re nowhere near done doing the job.”

Valrico resident Dawn McAlpin is among the new Affordable Care Act enrollees after signing up for a marketplace plan offered by Ambetter Sunshine Health for this year.

A longtime kindergarten teacher for Hillsborough County Public Schools, she retired in November and needs insurance to cover visits to an orthopedic specialist for a knee injury and an eye specialist to treat a glaucoma.

But she was told it would cost her $700 a month to keep her current insurance plan. That was beyond her budget because she lives on a pension and the 62-year-old won’t qualify for Medicare for another three years.

The district referred her to a Family Health Foundation office, where a navigator was able to find her a plan. The subsidy covers the total cost, so she has no premium.

“I was very happy, ecstatic,” she said. “Compared to $700, oh my God.”

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Stories like McAlpin’s were common through this year’s enrollment window, which ran from Nov. 1 to Jan. 15, said Katie Roders Turner, executive director of the Family Healthcare Foundation, a Tampa nonprofit set up to help residents of Hillsborough, Pinellas, Pasco and Polk counties find insurance.

Many of the new enrollees were retirees under 65 and people who had changed jobs and were still in the qualifying period for insurance with their new employer, she said.

Commonly known as “Obamacare,” the federal marketplace insurance plans were first offered in 2014, when enrollment was just over 8 million, and grew to 12 million by 2016.

The program stagnated under former President Donald Trump, when it was only saved from being repealed by the defection of three Republican senators in a dramatic 2017 vote. Trump’s administration also shortened the signup window for consumers to six weeks, slashed the program’s marketing budget by $90 million and cut $25 million from the funding for so-called navigators, who help people pick and enroll in insurance plans.

While the enrollment window is open only between Nov. 1 and Jan. 15, Roders Turner said the organization’s work continues all year long. Affordable Care Act rules allow enrollment outside of that period in the event of major life changes.

Florida is the nation’s third-most populous state but leads in Affordable Care Act enrollment by a sizable margin. California, whose population of about 39 million people is roughly 16 million more than Florida’s, has 1.6 million fewer residents enrolled.

One reason may be that those flocking to Florida use the federal program to get coverage while they find new jobs and get established, Roders Turner said.

“People aren’t flocking to California; it’s too expensive,” she said. “They’re coming to Florida in record numbers.”