Florida uses the federally run exchange, so people enroll through HealthCare.gov. Florida has the highest exchange enrollment of any state in the country.
Florida has the highest exchange enrollment of any state in the country
Open enrollment for 2021 health plans will start November 1, 2020, and continue through December 15, 2020. However, Florida residents with qualifying events can still enroll or make changes to their coverage for 2020. Especially in light of the COVID-19 pandemic that is making so many people lose their jobs — and their job-sponsored health insurance — it’s crucial to understand that losing the health plans you had at work counts as a qualifying event. This is true regardless of whether you’re allowed an option to continue your plan with COBRA (and it’s true even if you accept the COBRA offer; you still have the full 60 days to select a plan in the individual market if you prefer that option).
Unfortunately, Florida has a Medicaid coverage gap because 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, regardless of how low their income is). Individuals with income below the poverty level are also ineligible for premium subsidies. Florida could fix the coverage gap at any time by accepting federal funding to expand Medicaid. Still, they have not yet done so — even though two-thirds of Florida voters support Medicaid expansion.
Florida’s 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. One million nine hundred thirteen thousand nine hundred seventy-five people enrolled in plans through the Florida exchange during the open enrollment period for 2020 coverage. That was more than a 7 percent increase over the year before; Florida was one of only 11 states that used 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 marketplace plans was higher than it had been for 2018 plans.
Individual market enrollment is exceptionally high in Florida. Charles Gaba of ACA Signups calculated that nationwide, an average of 6.4 percent of the population was covered by different health insurance marketplace plans, including on and off-exchange policies, in 2017. But in Florida, it was double the national average, at 12.7 percent. And in South Florida, it was approximately 20 percent.
Florida has higher exchange trends than Texas and other states that have higher populations.
Florida’s market is more substantial than the small and large groups’ commercial insurance markets in Florida. However, some small groups and a significant portion of large groups (including a vast majority of huge groups) self-insure, so their numbers are not counted among commercial insurance enrollment totals.
California and New York both have larger populations than Florida. Still, unlike Florida, they have expanded Medicaid, which culminates in fewer enrollments in Florida private health insurance plans through the exchange. New York also debuted a Basic Health Program starting in 2016, which further decreases private health insurance plan enrollment. Texas also has a higher population than Florida and has not expanded Medicaid, but exchange enrollment in Florida is far higher than in Texas.
Starting in 2018, premium subsidies in the Florida exchange became much more abundant than they were in 2017, making coverage more affordable for many enrollees than it was in the past. That’s because the cost 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. This is described in more detail below.
2020 rates and plans: Overall average rates unchanged in the individual market
Florida already had a relatively robust single insurance market, and it got more robust in 2020. Bright Health joined the Florida exchange for the first time as of 2020, and Cigna rejoined the exchange in some areas of the state, after exiting the exchange at the end of 2015.
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