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Florida Needs Feds To Re-Open ACA Insurance Enrollment Amid Coronavirus

Florida is one of 32 states that has an Affordable Care Act marketplace that is run by the federal government. That means it's not up to the state to re-open enrollment.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Eleven states are allowing people without health insurance to sign up for Obamacare in light of the coronavirus pandemic. But that may not be a reality in Florida.

Florida is one of 32 states that has an Affordable Care Act marketplace that is run by the federal government. That means it's not up to the state to re-open enrollment.

The Centers for Medicare and Medicaid Services said it’s “evaluating offering a Special Enrollment Period specifically for COVID-19.”

“We will continue to work closely with states and health plans around the country to assess what additional actions are necessary to ensure the American people have coverage for and access to the services they need during this time," an agency spokesperson said in a statement.  "CMS’s top priority is protecting the health and safety of the Americans we serve.” 

Anne Swerlick, senior policy analyst with the Florida Policy Institute said it’s critical for residents in the state to get another opportunity to get coverage because people without insurance may avoid seeking care if they are sick, which could help the virus spread.

“We already have over 2.5 million Floridians that are uninsured and of course the number is just going to keep growing as people are losing their jobs and employer-sponsored coverage,” she said.

People who have lost job-based insurance or are dealing with certain other life-changing circumstances are already allowed to enroll in the marketplace at any time.

Depending on what Special Enrollment period they qualify for, they're given a set window of time to sign up for a new plan, typically about two months. 

“A lot of people don’t know what the circumstances are when they could qualify for special enrollment, so just a blanket re-opening of enrollment would certainly cut down on the complexity for people to have to sort through all of that,” said Swerlick.

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More than 1.9 million Floridians signed up for health coverage through the federal marketplace during the enrollment period that ended last December, the most since the marketplace began in 2014.

Swerlick said the coronavirus pandemic also highlights the need for Medicaid expansion in Florida.

People are allowed to enroll in Medicaid at any time, so that could have been an option for some residents even if the federal government chose not to re-open the marketplace.

But the state’s current eligibility requirements for Medicaid are strict both in terms of income limits and categories of people who qualify.

"For example if you're a single person, even if you have no income, if you don't have severe disabilities you're not going to qualify for Medicaid," said Swerlick.

Medicaid eligiblity in the state is determined by either the Florida Department of Children and Families or the Social Security Administration.

States with Medicaid expansion help fill gaps in coverage for people who may not qualify for standard Medicaid but also don't earn enough to get marketplace subsidies under the Affordable Care Act.

Florida is one of 14 states that has not yet expanded Medicaid.

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Stephanie Colombini joined WUSF Public Media in December 2016 as Producer of Florida Matters, WUSF’s public affairs show. She’s also a reporter for WUSF’s Health News Florida project.