Open enrollment on HealthCare.gov started Sunday, and federal health officials expect the third year of open enrollment to be more challenging than in previous years.
"We've probably grabbed the low-hanging fruit,” HealthCare.gov Chief Executive Officer Kevin Counihan said. "We're now at the high-hanging fruit, and that's a lot more difficult. It requires a certain level of engagement and patience sometimes.”
Florida led in sign-ups last year, with about 1.6 million people enrolling because they could not obtain plans through an employer, or afford to buy a plan on their own.
"We've got to be very creative, we've got to be very aggressive about how we're getting out to places where transportation is an issue, where we know languages are a barrier,” said Jodi Ray, who directs Florida Covering Kids and Families at the University of South Florida and oversees Affordable Care Act navigators across the state for that program.
"It was really a lot easier in the first two years to cast a wide, but we really need to make sure that we're honing in on folks who can't be reached by some of the more general and non-specific communication strategies."
In 2016, it can cost $695, or as much as 2.5 percent of household income, to go without health coverage under the federal health law. Ray said there will be a big focus on that larger tax penalty, and on educating consumers about things such as understanding co-pays, co-insurance and deductibles.
"We want to make sure that people know how to use their health insurance,” Ray said. “That's going to be a really big part of this year, making sure that we're really helping people understand what the value of having health insurance is for them."
More than 90 percent of Floridians who bought a plan for 2015 on the federal marketplace got subsidies to cover part of the monthly premium.
To have coverage that starts Jan. 1, 2016, consumers have to enroll by Dec. 15. Open enrollment on HealthCare.gov ends on Jan. 31, 2016.
Lottie Watts is a reporter with WUSF in Tampa. Health News Florida receives support from the Corporation for Public Broadcasting.