2021 Obamacare enrollment begins
Floridians led the nation in enrollment.

"Health insurance isn't a sexy topic, you know.”

Despite an ongoing legal challenge — and constant criticism from many Florida politicians — a key moment is coming up for Obamacare.

Open enrollment in the federal health exchange for 2021 health care coverage begins Sunday and ends Dec. 15.

Jodi Ray, executive director of the Florida Covering Kids and Families program at the University of South Florida in Tampa, says she doesn’t know quite what to expect Sunday morning when open enrollment begins, but she is expecting interest to be high.

After all, no state has had greater enrollment in the federal health exchange than Florida. There were about 1.9 million Floridians enrolled this year.

“Despite it not being a politically inviting environment for the ACA, Floridians on the ground wanted coverage and access to coverage,” Ray told The News Service of Florida, referring to the Affordable Care Act, commonly known as Obamacare.

And she doesn’t expect COVID-19 or a pending U.S. Supreme Court hearing over the constitutionality of the federal law to change that.

Ray’s group spearheads the state’s health exchange enrollment navigation efforts.

Navigators are established in the federal law as advisers who help people traverse what can be difficult terrain: securing health insurance.

Navigators can be individuals or organizations. They are trained to help people considering health-coverage options through the federal exchange, including completing eligibility and enrollment forms. Navigators are required by law to be unbiased.

Ray, who subcontracts with seven advocacy organizations across the state to provide navigator services, says she and others have been busy since the 2020 open-enrollment period ended because the coronavirus pandemic quickly followed. More than 1 million Floridians lost their jobs as a result of the virus, and many of them also lost their employer-sponsored health insurance.

The 2010 Affordable Care Act put into federal law standards that health insurance companies and HMOs must abide by and precluded states from weakening those standards.

The federal law requires health insurers to offer policies to people regardless of preexisting conditions and prevents companies from charging rates based on health factors. The law also authorized states to expand Medicaid to low-income childless adults — which Florida has not done — and established a federal health-insurance exchange where people can purchase subsidized coverage.

The exchange, operated by the federal government, is where low-income individuals can purchase insurance and obtain subsidies to help pay for the coverage. The federal law allows people to apply for coverage on the federal exchange after open enrollment ends, under certain circumstances such as loss of employment.

“We have had a steady rate of enrollments since (2020) open enrollment ended. We didn’t have any deficits in enrollment. We have been busy,” Ray said.

Ray said her office has been fielding questions from state residents who lost their jobs and their health insurance while also hearing from residents of New York and California who are considering relocating Florida, where it is less expensive to live.

“You can’t afford to be out of work and live in states like that,” she said.

Ten health insurance companies and HMOs are participating in the federal exchange this year. Blue Cross Blue Shield of Florida offers policies in every county, the only carrier to do so. Celtic Insurance Company offers policies in 63 counties but does not offer health insurance to residents of Hendry, Martin, Monroe and Taylor counties.

More insurance companies are offering plans during the 2021 open-enrollment period, but the cost of coverage will be slightly higher, mostly attributable to the COVID-19 pandemic. Florida Insurance Commissioner David Altmaier approved a 3.1% increase for the 2021 rates.

Ray’s group already had embraced virtual platforms to assist in their enrollment efforts before the coronavirus pandemic, in response to President Donald Trump‘s drastic reduction in the amount of federal funding to support navigators.

“We developed that two years ago so when COVID-19 hit, we were already doing that. I think that allowed us to seamlessly move into the new way of doing things,” said Ray, whose group received a $1.6 million grant from the federal government.

But navigators still offer face-to-face appointments for people who need assistance, Ray said.

“Navigators don’t do this work because it’s a good time. It’s hard work. It’s mentally exhausting. It’s physically exhausting. We are entering into what is equivalent of tax season for accountants for that six weeks. And the prep that goes into it is a lot of hard work as well,” said Ray, who has worked to help people find access to health care for more than 20 years. “It’s not exactly a high-paying job. It’s not like being an accountant. And yet you have people who do this work not only because not only they are passionate about it but because they have a lot of compassion for the people they are trying to help. … When it comes down to it, we can talk about health insurance all we want.  But we are trying to give people access to health care. When you think about it that way, it’s a lot more important than just narrowing it down to ‘health insurance.’ Health insurance isn’t a sexy topic, you know.”


Republished with permission of The News Service of Florida.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


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