Open enrollment for health insurance through the Affordable Care Act (ACA) ends Saturday and, except for special circumstances, will stay closed until the 2023 period opens late this year.
Congress passed the ACA—also known as Obamacare—in 2010, and it has operated since then, despite changes from federal agencies, Congress and court decisions.
Keith Black, a navigator with Suwannee River Area Health Education Center, says most applicants have the process down now. But with more than 100 plans to choose from, plus healthcare and government jargon, the process can still trip up new applicants.
That’s where Black comes in.
Suwannee River Area Health Education Center operates in 12 counties across North Florida, including Alachua, Marion, Levy, Putnam, Gilchrist and Columbia. The nonprofit focuses on tobacco addiction and other community health issues—like insurance.
Black guides people through the ACA system, and with six years of experience as a navigator, he can narrow down the best plans for people, saving them a lot of time. But he said picking a plan is still the most difficult part.
He said the end of the open enrollment period is motivating a surge of last-minute applicants
“I saw an increase last week,” Black said. “Most people have already chosen plans and enrolled.”
Black also has also seen an increase in applicants since the COVID-19 pandemic.
In February 2021, the U.S. Department of Health and Human Services (HHS) reported that 2,018,631 Floridians obtained health insurance coverage through the ACA marketplace. Nationwide, just under 31 million people had enrollment with ACA, up from 27 million in 2020.
Florida has more citizens signed up for ACA coverage than any other state—by more than a half-million people. California and Texas come in second and third with 1,583,781 and 1,210,431 respectively.
ACA contains two main areas of coverage: Medicaid and the marketplace.
HHS estimates that 760,000 Floridians would qualify under the expanded Medicaid bracket. Currently, 11 other states utilize the marketplace but have not expanded Medicaid coverage.
Former Gov. Rick Scott, a Republican, said he would push to expand Medicaid in Florida, but the effort never came to fruition.
Most of the split over ACA falls along party lines, and it continues to divide Republicans and Democrats 11 years after passage.
Multiple cases concerning the bill have reached the Supreme Court, most recently in June 2021. The high court voted to dismiss the case, 7-2, saying the states bringing the litigation did not have standing to sue.
In Marion County, where Black works, people who’d never had coverage before signed up. Black said the global health pandemic had a hand.
He said some people had never signed up because they’d always been healthy and lacked a reason.
But unemployment also played a role. When people lost their jobs during the 2020 shutdown, many also lost the health coverage that came with their employment, leading more to turn to the ACA for coverage.
“Biggest impact I’ve seen is people have been able to maintain health coverage,” Black said.
The federal government worked to increase access to the coverage, extending the enrollment period and adding premium reductions.
During a special enrollment period from February 15 through August 2021, more than 1 million Americans signed up in the first three and a half months.
Because Saturday represents the last chance for most people to sign up for 2022 coverage, the Suwannee River Area Health Education Center is holding a special Alachua County signup event to get a last push of signees.