ACA enrollment starts Saturday; premium increases expected

Ocala Star Banner
By Fred Hiers

This is open enrollment season for private sector insurance plans, Medicare Advantage plans, and the plans getting the most attention the past two years: those in the Affordable Care Act’s marketplace of health insurance offerings.

Enrollment for the latter group starts Saturday. Since the program’s debut last year, the number of uninsured residents has fallen across Florida, including a significant drop in Marion and neighboring counties.

The percent of uninsured residents in Marion County fell from 24 percent in 2013 to 17 percent in 2014, according to Enroll America, a nonprofit that works to find health insurance for people. Levy County saw its uninsured drop from 27 percent to 17 percent this year, and Alachua County saw a decrease from 20 percent to 15 percent.

Families USA, a Washington-based nonprofit group and supporter of the Affordable Care Act, said such decreases can be attributed to the ACA making insurance available to many who would otherwise go without.

“It really changed the ability of people to get coverage,” said Families USA Executive Director Ron Pollack.

As for the uninsured rates dropping, Pollack said, “a lot of this has to do with getting coverage in the marketplace and getting” government subsidies for those who need the financial help.

He said that for counties such as Marion, with especially high numbers of poor or employed with no employer-offered insurance, the Affordable Care Act will continue to be a health care lifeline — and more people locally will want it.

There are seven health care companies that make up the marketplace plans for Marion County, according to the Florida Department of Insurance Regulation. But agency spokesman Harvey Bennett said the agency has not yet tabulated how many individual plans there are to choose from.

Saturday will also mark the first day the federal government’s will be used to renew policies for clients with existing Affordable Care Act coverage. Florida officials overseeing enrollment will only have three months — half the time they had the first time around.

Last year, nearly 1 million Floridians signed on with the federal health care marketplace, more than any other state, according to the Associated Press. But that also means those working to re-enroll clients will have their work cut out for them.

“We’re going to have our hands full,” said Jodi Ray, who oversees the University of South Florida’s “navigator” program, which has more than 150 health counselors assisting consumers from Key West to Pensacola, the AP reported. The program is expanding its outreach to healthy, young adults and getting increased support from local hospitals to target uninsured Floridians.

The bugs have supposedly been removed from the famously troubled website, which can withstand last season’s peak loads and beyond with at least 125,000 simultaneous users. The online application has been pared from 76 screens to 16 for most consumers.

In 2015, the federal government will continue to subsidize payments. In Marion County, the average monthly cost to individuals earning $27,000 annually and enrolled in the marketplace’s Silver Plan, which accounts for about 70 percent of Florida enrollees, is $218 per month, which also includes a $48 monthly federal subsidy, according to the state Department of Insurance Regulation.

That is an increase from 2014, when area customers’ monthly cost was $202, which included a $41 subsidy.

For a family of four with a $51,000 annual income, the cost for the same plan in 2015 will be $465, with a $473 subsidy covering the rest. In 2014, the individual contribution for that plan was $409.

The monthly costs are typical throughout Florida; state insurance officials have said consumers could expect an average premium increase of 13 percent, the AP reported.

Insurance companies say volume will always be an issue because ACA’s open enrollment coincides with Medicare enrollment and many large private groups also renew their policies in January. But insurers say they’ve expanded bandwidth, added staff and increased customer service hours.

Two Marion County residents benefitting from the Affordable Care Act are Robert Bealer and his wife, Everin Quintero-Bealer.

Everin Quintero-Bealer, originally from Colombia, married her American-born husband 12 years ago and moved to the United States two years ago. She remains a Colombian citizen.

“We didn’t have insurance,” he said. “When she got sick we did what we always did: plan on paying for what we could.”

She was born with no arms or legs, and does not qualify for Medicaid. Last year she and her husband purchased one of the federal marketplace plans.

The Marion Oaks couple is still paying off some of her previous medical bills at $10 a month.

Under the Affordable Care Act the couple now has a policy that covers them both. The cost would regularly be $570 per month this year, but with federal subsidies the couple pays $45.43 per month.

He said the federal program has been a huge help.

“The amount we pay I mostly like,” he said, but added he worries about premiums rising in the future.

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