A.G. Gancarski
Year over year, fewer people are signing up for Affordable Care Act protections, a trend solidifying ahead of the Dec. 15 deadline.
According to the Centers for Medicare and Medicaid Services (CMS), 799,118 Floridians enrolled in December. That number is down from 802,711 the previous year.
The spread is even starker when national numbers are rolled in: 3,198,163 versus 3,604,440 last year.
Activists are concerned.
“Having health insurance means being able to go to the doctor when you are sick or accessing preventive care to address a health issue before it becomes something more serious,” said Scott Darius, executive director of Florida Voices for Health.
“Families that sign up for health care coverage through the Affordable Care Act may qualify for financial assistance and can have peace of mind throughout the year that they are purchasing a quality insurance plan that will be there for them when they need it,” Darius added.
Another activist notes unique benefits of plans from the Affordable Care Act marketplace.
“All health insurance plans sold in the Marketplace must cover the ten essential health benefits, such as preventive and wellness services, prescription drug coverage, emergency care, and mental health and substance use disorder treatment,” said Mark Ferrulo, executive director of Progress Florida.
“It is important that people read the details for any health insurance plan purchased outside the Marketplace, because they do not necessarily have to cover these essential health benefits,” Ferrulo added.
Florida, according to the Kaiser Family Foundation, has over 631,000 people who could get the costs of a Marketplace policy defrayed entirely by premium tax credits.
However, there is a catch: Those plans have an average deductible of $6,258, a number daunting to many. Some deductibles are as high as $15,000.
Kaiser recommends that people consider silver plans, where the higher premiums are often absorbed by the tax credit, but a lower deductible is offered.
There are, of course, caveats to this sweeping analysis.
Each insurance offering comes with one catch or another, including co-pays and cost-sharing that can disincentivize uses of the medical procedures insurance covers.
The conservative Heritage Foundation noted the problems for the insurance industry that led to escalating costs: “a risk pool consisting of older, less-healthy, and costlier-to-insure individuals.”
“More than half of all plan designs (54.7 percent) in the 39 states using the federally run exchange (Healthcare.gov) set out-of-pocket limits at the maximum allowed by the ACA,” Heritage notes.
