Saturday at midnight is the deadline to sign up for health insurance next year through the federal marketplace established by the Affordable Care Act, which enables millions of Americans to obtain needed medical care. Enrollment in Florida again leads the nation and is likely to surge past 1 million by the deadline. Despite the Trump administration's deliberate efforts to undermine the law, popular support continues to grow because the simple truth is Americans want affordable, accessible health care.
The law aimed to reduce the number of uninsured Americans in part by establishing the federal marketplace and similar state-run exchanges, where individual Americans can purchase policies from mainstream private providers. Those plans are generally available in gold, silver and bronze levels and vary by cost and what they cover. Most purchasers qualify for some subsidy based on their income, keeping premiums at a much more affordable level.
For example, using the Kaiser Family Foundation's marketplace calculator to estimate 2019 monthly out-of-pocket premiums:
• A 30-year-old non-smoker in south St. Petersburg earning $30,000 a year would receive a premium tax credit of $226 per month for a silver plan, bringing the monthly payment to $207.
• A 25-year-old nonsmoker in Brandon who earns $25,000 would receive a $232 credit for a silver plan, and pay about $141 a month.
• A 55-year-old non-smoker in New Port Richey earning $35,000 annually would receive a credit of $563 a month for a silver plan, paying $277 a month out of pocket.
For individuals, the savings are significant and can mean the difference between having good insurance or going without it completely. Since the law passed at the end of 2010, nearly 20 million more Americans are insured. Yet last year, Trump administration officials declared the law "dead." Perhaps that was wishful thinking, because the administration has certainly done its best to kill it. For the first time, the federal government is not enforcing the law's tax penalty imposed on people who decline to get coverage, known as the individual mandate. It's a reasonable requirement that helps keep costs down for everyone by ensuring not just older, sicker people are in the insured pool. But Republicans have absurdly branded it as an attack on individual freedom.
The law originally included a nationwide expansion of Medicaid, broadening eligibility for poorer Americans to qualify for the program. But the U.S. Supreme Court ruled it should be left up to the states whether to expand Medicaid, and the Republican-controlled Florida Legislature has refused to approve the expansion even though it would bring billions in federal dollars and insure 800,000 low-income Floridians.
The spending cuts to promote signing up for health coverage through the federal marketplace means smaller campaigns to reach people who may not know they can qualify for a tax subsidy and fewer navigators to help them sign up. Thankfully, Americans are voting with their feet and continuing to sign up, even if Republicans in Washington and Tallahassee refuse to listen.
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There is still time to enroll for next year, but the clock is ticking. Go to CoveringFlorida.org or CoveringTampaBay.org for help signing up; call the Family Health Care Foundation at (813) 995-1066 or Covering Florida at (877) 813-9115; or sign up on your own at healthcare.gov.