Amid a hectic year for Florida health care, the state could be on track for another record-breaking year in enrollment through the Affordable Care Act, local experts say.
In the first week of the enrollment period, which began Nov. 1, the Family Healthcare Foundation had scheduled more than 100 appointments with clients to go over plan options, said Katie Roders Turner, executive director. “And we’re on track to continue that trend.”
The foundation has also increased online advertising, and with its partners is sending 35 health care navigators across Tampa Bay, including 15 locations in Hillsborough County alone.
“I would say that’s probably the busiest I’ve ever seen us, in terms of scheduled appointments, in the 10 years I’ve been doing this,” Roders Turner said. She added that the foundation’s call volume has been elevated since the state’s Medicaid redetermination process began in April. “We know that people are looking for coverage options, right now.”
Enrollment in the federal health care marketplace, signed into law by former President Barack Obama, has been on the rise nationwide since the pandemic, when new subsidies offered expanded coverage options for families above the federal poverty level.
Florida has consistently led the nation in enrollment. Last year, a record 3.2 million residents signed up for 2024 coverage in the federal marketplace, about 20% of the national total. There were also about 500,000 more Floridians than the year prior.
“We see this in other states that haven’t expanded Medicaid as well,” Roders Turner said. “We also do have a pretty large population of people. We’ve seen huge increases in population, especially here in Tampa Bay. So I think as people continue moving to the state of Florida, we’re going to continue seeing those increases in enrollment.”
Advocates say many of those who lost Medicaid eligibility this year could qualify for marketplace subsidies — but it’s difficult to say how many.
“I think given that the trends of marketplace enrollment in Florida for past years were exceptionally high, even with Medicaid Continuous Coverage, there is an expectation that we will see a continued increase for 2024 marketplace enrollments due to the Medicaid redeterminations,” Roders Turner said.
To qualify for subsidies on the federal marketplace as an adult, a policyholder must have a projected income of 100% of the federal poverty line for 2024. For example, this means one individual must make at least $14,580, while a family of four must make $30,000. If they expect to make less than that, they might not qualify for subsidies or meet the state’s strict Medicaid standards. Adults without children are not eligible for Medicaid in Florida, regardless of income.
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Jodi Ray, program director of Florida Covering Kids & Families, said the challenge will be ensuring everyone who should logically switch to the federal marketplace makes it over. Ray said she’s heard from hospital partners about patients undergoing cancer treatment or maternal care who have had coverage abruptly stop.
But ensuring coverage has already proven a challenge: Although children who lost Medicaid this year are supposed to be automatically switched to alternatives like the Children’s Health Insurance Program, state data has shown that’s not happening in the majority of cases.
“The best we can do is keep trying to help as many of these individuals as possible from falling through the gap,” Ray said.
Tampa Bay is in a unique position in that there are county-based programs that serve patients with the greatest financial need, Ray said. Free health coverage is available to residents of Hillsborough, Pinellas and Polk Counties who don’t qualify for marketplace subsidies or Medicaid.
The deadline to receive 2024 coverage starting in January is Dec. 15; the final deadline, for coverage beginning in February, is Jan. 15.