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  1. Health

Uncertainty over Obamacare's future sends premiums up, budgets down

Open enrollment for individual health insurance is still about a month away, but insurance companies and "navigator" programs that help people find coverage are already bracing for what's likely to be a rocky year ahead.

Premiums for health care plans sold on the Affordable Care Act's federal exchange and outside the exchange will rise an average of 45 percent in Florida this year, according to prices released this week by Florida's Office of Insurance Regulation. Insurers blame the rate hikes on the uncertainty surrounding the future of Obamacare, given recent repeal attempts in Congress to repeal the law.

At the same time, Florida's navigators, the non-profit and public-private groups funded by the government and through grants to help the uninsured sign up on the exchange, have had their budgets slashed.

PREVIOUS COVERAGE: Insurers request steep premium hikes for Florida, but Obamacare subsidies may offset the impact

And it doesn't help that the open enrollment period — the fifth since the marketplace began in 2013 — is the shortest it's ever been. The period is half the length of last year's, beginning Nov. 1 and ending Dec. 15. So advocates are gearing up to educate consumers about the options now.

"Florida has more people enrolled in the marketplace than any other state," said Anne Swerlick, an attorney and analyst with the Florida Policy Institute. "Navigators play a key role in getting the word out, especially this year, when the enrollment period is reduced. There's a fear that many people may not be reached, which is a real concern in Florida where there's still 2 million people uninsured."

There are six health insurers who will sell Obamacare plans on the federal marketplace in Florida come 2018. While all six requested double-digit rate hikes, the state has the power to negotiate them down, and Obamacare subsidies will significantly reduce premiums for many consumers.

But those who have coverage with Florida Blue, the state's largest insurer, could see significantly higher premium increases in 2018 compared to 2017. That's because the company anticipates that the government may stop paying one kind of subsidy known as a "cost-sharing reduction," which lowers the amount people pay for deductibles, copayments, and coinsurance. Florida Blue factored the projected added cost into its 2018 premiums, said David Pizzo, the Florida Blue market president for the West Coast region.

Those most affected are about 7 percent of the 1 million Florida Blue consumers with so-called "silver" plans in the state's federal marketplace, or about 66,000 people.

But Pizzo added that the company is offering a dozen new plans outside of the Obamacare exchange that will be similar in price and coverage to the exchange's silver plans from previous years.

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Meanwhile, navigators are preparing to do more with less in anticipation of the open enrollment period in Florida.

"A lot of what we're doing now is just reminding consumers that we still exist," said Jodi Ray, director of Florida Covering Kids & Families, a navigator program based at the University of South Florida. "A lot of that has been driven by misinformation over the last 9-10 months. People are confused and think the ACA is gone."

Covering Florida Kids & Families took a 15 percent cut to its budget this year, which equates to almost $900,000, Ray said.

"It was painful," she said. "That's a lot of resources. It's impactful and it's unfortunate."

She said the biggest challenge ahead is deciding where to allocate their limited resources.

"We are working with some of the most vulnerable people in the state. Sometimes they live in rural areas, which can be harder to reach and where offices aren't accessible, so we have to go to them. That takes time and more resources," Ray said.

The Epilepsy Foundation of Florida, another statewide navigator based in Miami, shuttered earlier this month when its contract wasn't initially renewed. It reopened a few weeks later with a new contract, but with a budget that was cut by 58 percent or nearly $1 million, said the organization's CEO, Karen Egozi.

"Our job has always been to help people," she said. "We're really pleased that we're going to be able to do that again for fifth year, despite the cuts."

But like Ray, she was unsure about the organization's future.

"It's important work and we'll keep doing it for as long as necessary," Egozi said. "If health care changes in this country, our role may become even more important. So many Americans are already confused or uneducated about this now."

Contact Justine Griffin at or (727) 893-8467. Follow @SunBizGriffin.