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Florida Health Insurance Exchange

Florida uses the federally run insurance marketplace, so residents enroll through HealthCare.gov. Florida has the highest exchange enrollment of any state in the United States.

Open enrollment for 2021 health plans will start November 1, 2020, and continue through December 15, 2020. But Florida inhabitants with qualifying events can still enroll or make changes to their coverage for 2020.

Particularly in light of the COVID-19 pandemic that is causing so many individuals to lose their jobs — and their job-sponsored health insurance — it’s essential to understand that losing the health insurance plans you had at work counts as a qualifying event. This is true irrespective of whether you are offered an option to continue your plan with COBRA (and it’s true even if you accept the COBRA offer; you still have 60 days to choose a health insurance plan in the individual market if you prefer that option).

Regrettably, Florida has a Medicaid coverage gap since the state has rejected federal funding to expand Medicaid. Consequently, households with income below the poverty level are not automatically eligible for Medicaid (very low-income parents are qualified, but non-disabled childless adults are not, irrespective of how low their income is).

Persons with income below the poverty level is also ineligible for premium subsidies. Florida could fix the coverage gap at any time by accepting federal funding to expand Medicaid, but they have not yet done so — despite the fact that two-thirds of Florida electorates support Medicaid expansion.

The Florida health insurance exchange enrollment each year is by far the highest of any state in the country — almost 17 percent of the country’s exchange enrollees are in Florida. 1,913,975 persons enrolled in plans through the Florida exchange during the open enrollment period for 2020 coverage.

That was more than a 7 percent rise over the year before; Florida was one of only 11 states that utilized HealthCare.gov to see the higher enrollment for 2020 than they’d had for 2019. And Florida was one of just nine states where enrollment during the open enrollment period for 2019 health insurance plans was higher than it had been for 2018 plans.

Individual Market Enrollment in Florida

Individual market enrollment is mainly high in Florida. Charles Gaba of ACA Signups calculated that nationwide, an average of 6.4 percent of the population was covered by individual market plans, as well as on and off-exchange policies, in 2017. But in Florida, it was double the countrywide average, at 12.7 percent. And in South Florida, it was almost 20 percent.

Florida’s individual market is larger than both the small group and large group commercial insurance markets in Florida. However, some small groups and a significant portion of large groups (as well as a large majority of very large groups) self-insure, so their numbers are not counted among commercial insurance enrollment totals.

California and New York both have larger populations than Florida, but unlike Florida, they have both expanded Medicaid, which contributes to fewer enrollments in private plans through the exchange, and New York also debuted a Basic Health Program starting in 2016, which further lessens private plan enrollment. Texas also has a higher population as compared to Florida and has not expanded Medicaid, but exchange enrollment in Florida is far higher than in Texas.

Beginning in 2018, premium subsidies in the Florida exchange became much larger than they were in 2017, making coverage for many enrollees cheap than it was in the past. That’s because the price of cost-sharing reductions (CSR) is now added to silver plan premiums in Florida. The subsidies are based on keeping the after-subsidy cost of the second-lowest-cost silver plan affordable.

Resources and References:

• Medicaid Plans
• Cost Sharing Reduction