Open enrollment begins today for the Affordable Care Act, and local advocates worry that health insurance changes this year might confuse consumers and keep them from selecting the best plans for their health.
A recent change by the Trump administration will allow insurance companies to sell short-term health care plans that are generally cheaper, less comprehensive and not on the federal health care exchange. The problem, local advocates say, is that consumers who have previously enrolled through the Affordable Care Act and switch to a cheaper short-term plan may find their insurance won't cover the same major expenses.
"These types of plans do not have to have the same minimal essential coverage that is outlined by the Affordable Care Act," said Melanie Hall, executive director of the Family Health Care Foundation in Tampa Bay, which helps people sign up on the federal exchange. Those essential benefits include colonoscopies, mammograms and maternity care, among other preventative care options guaranteed under Affordable Care Act, also known as Obamacare.
In addition, short-term plans do not have to cover preexisting conditions.
"Short-term" means these plans expire within a year. In Florida they expire in six months, as regulated by the state's office of insurance regulation. Consumers can renew them for up to three years.
"They are a cheaper alternative but they are considered catastrophic safety net coverage," Hall said. "They may be more attractive to people who don't qualify for tax credits and subsidies and are looking to pay slightly less premiums. But we encourage those people to go into this coverage with their eyes wide open, as they won't have the same access to care and their medications might not be covered."
This isn't the first example of private insurers offering health plans not on the federal exchange. Florida Blue, the state's largest insurer, will offer additional plans off the exchange for the second time this year. The non-Obamacare plans will be similar in price and coverage to those on the exchange. The company started offering them in response to last year's premium increases on so-called Silver plans, which are priced in the middle range and are among the most popular Obamacare options.
More than 1.7 million people in Florida were insured through Obamacare last year as the state led the nation in enrollment. Forecasts show that Florida stands a good chance of keeping that distinction; it's among the states expected to see the slightest premium increases for 2019.
Prices overall are staying roughly the same as last year, after premiums shot up on some plans when the federal government ended its cost-sharing relationship with insurers. Cost-sharing helped keep the price of deductibles, copayments and coinsurance low.
But those responsible for telling people about their options on the federal exchange say they are facing some headwinds that don't bode well for Obamacare.
For the second straight year, the government has drastically reduced funding for marketing Obamacare plans. Local "navigators" who help consumers enroll in health care plans in person and over the phone said the cuts have forced them to pick and choose where they invest resources.
"We have a fraction of the navigators we've had in the past, in about half the counties," said Jodi Ray, executive director of Florida Covering Kids & Families, a navigator program based at the University of South Florida.
The USF group received $4.9 million in federal funds last year for open enrollment marketing and consumer assistance. It was one of several groups in the state to receive funding.
This year it received $1.25 million, and is the only organization in the state to receive any funding.
Ray worries that fewer people in Florida will sign up without the assistance of navigators. Last year, her office was fielding more than 1,000 calls a day toward the end of the enrollment period.
"We've never been in this situation before, so I don't know how prepared people are to sign up on their own," Ray said. "But we're doing in-person appointments, virtual appointments and enrollment over the phone."
Open enrollment runs from Nov. 1 to Dec. 15.
Contact Justine Griffin at email@example.com or (727) 893-8467. Follow @SunBizGriffin.