To borrow Mark Twain's phrase, the reports of the Affordable Care Act's death are greatly exaggerated. The fifth year for open enrollment starts today for health insurance available on the federal marketplace, and Floridians should be aggressive in reviewing their options even if they already receive coverage through it. The clock is ticking, and don't be scared off by the sticker price because most Floridians on the exchange qualify for subsidies to lower the cost.
It will take more work and a greater sense of urgency for families to evaluate their options for health coverage in 2018. The enrollment window is shorter than ever and ends Dec. 15. The Trump administration has slashed spending on advertising, so there won't be the marketing on television and elsewhere that there has been in past years. Funding also has been cut for navigators who help consumers figure out their best choices, so it's going to take a concerted grass-roots effort to get the word out.
First, navigators and elected officials throughout the state have to convince Floridians that the Affordable Care Act remains in place and has not been repealed. Congressional Republicans tried to repeal it but could not come up with the votes, and President Donald Trump has called the law "dead.'' But the law is very much alive, and there is still the requirement on federal income tax returns to report that you have health insurance coverage or risk paying a financial penalty.
Second, even Floridians who already receive health insurance through the federal marketplace should check their options. Unlike previous years, those consumers may not receive a notice encouraging them to shop around before they are automatically re-enrolled in the same plan if they fail to sign up before Dec. 15. That's a big deal in Florida, which has more residents covered with health insurance through the federal marketplace than any other state — some 1.4 million people.
Third, don't be scared off by sticker shock. Health insurance premiums on the marketplace are expected to rise by an average of 45 percent next year, but that's misleading. The Kaiser Family Foundation reports the premium increases range from a more manageable 7 percent up to 38 percent for silver plans, which are the most common choice. And about three out of four Floridians qualify for a subsidy that can substantially lower the premium.
Fourth, don't be confused by Trump's wrongheaded move to end the government payments to health insurers that help cover out-of-pocket expenses such as deductibles and co-payments for low-income consumers. Florida insurance regulators planned ahead and required insurers to set their rates assuming the federal payments would end before the president even acted. And in an odd twist, because the premiums went up, so will the tax credits to offset the increase; some Floridians could even come out better off. For example, the state says, a family of four with an income of $53,000, or an individual earning $27,000, may see a slight decrease in costs in 2018 for a silver plan.
The Affordable Care Act obviously has its shortcomings and needs to be improved, not repealed. But it is still very much alive, and it has been successful in significantly lowering the number of uninsured residents in Florida and the nation. Starting today, it's important to keep that trend headed in the right direction and help Floridians who need health insurance find a plan that works for them in the next six weeks.