Florida Leads Nation In ACA Sign-Ups

Dec. 30--More than 670,000 Floridians have signed up for health coverage under the Affordable Care Act for 2015, the most of any state using the federal marketplace, according to federal data released Tuesday.

And 94 percent of Florida enrollees will receive financial aid from the government, the U.S. Department of Health and Human Services announced.

The federal data track the number of consumers who signed up between Nov. 15 and Dec. 15, the first month of open enrollment for the law popularly known as Obamacare.

This year's enrollment has run far more smoothly than the disastrous inaugural sign-up period in 2013, when a glitchy healthcare.gov website prevented people around the nation from selecting a plan.

Fewer than 18,000 Florida residents were able to select a plan during the first two months of enrollment that year.

"We're pleased that in Florida 673,255 people signed up for Marketplace coverage during the first month of open enrollment," said HHS Secretary Sylvia Mathews Burwell in a press release. "We still have a ways to go ... but this is an encouraging start."

Enrollment ends Feb. 15.

Florida leads the nation in the number of people signing up in the 37 states using the federal exchange at healthcare.gov, according to the recently released data. Texas was No. 2, with more than 379,000 consumers signing up.

Florida is the second-biggest state using the federal exchange after Texas. Some states with large populations, including California and New York, have established their own state-based marketplaces.

Percentage-wise, the state's performance is on par with how it did last year, said Caroline Pearson, vice president at Avalere Health, a healthcare advisory firm in Washington, D.C.

"Last year at the end of open enrollment, Florida accounted for 18 percent of customers on the federal exchange," Pearson said. "So far this year, it's 19 percent."

People who signed up last year said health coverage has helped change their lives.

Fabiola Alfred, 34, of Miami, said that before the health law went into effect she had never been able to afford health insurance despite holding several part-time jobs as a healthcare worker.

"I could afford to buy food or go to the doctor," said Alfred, a mother of three. "But not both."

Alfred had applied for Medicaid repeatedly, but each time state officials told her her income was too high. She signed up for Obamacare coverage last year after hearing an advertisement on television, and recently renewed her family plan for 2015.

Having health insurance was a "blessing" when she was pregnant with her youngest son, who is now 2 months old, Alfred said.

"I went to the doctor whenever I needed and the co-pay was only $15," she said.

People who signed up last year but, unlike Alfred, failed to choose a new plan for 2015 were automatically re-enrolled in their existing coverage on Dec. 15.

The recently released federal numbers do not include state-level data on consumers who were automatically re-enrolled.

That means the actual number of Floridians with coverage for 2015 could be much higher than 670,000.

HHS likely will release the number of total sign-ups in the state next month.

At least 7.1 million Americans have selected a plan for next year, counting automatic re-enrollments, which are available at the federal level. The Obama administration has set a target of about 9.1 million enrollees for 2015.

Pearson, the analyst at Avalere Health, said the government may meet that goal, but the new numbers show it is failing to sign up young people, Hispanics and African Americans at a high enough rate.

"The demographics are tracking pretty similarly to last year, which is really not what people who want the exchanges to succeed are hoping for at this point," Pearson said.

Only 11 percent of people who signed up around the country so far are African American, and just 8 percent are Hispanic.

People between 18 and 34 -- who are crucial to the exchange because they are generally healthier and help subsidize coverage for older, sicker consumers -- make up 24 percent of enrollees so far.

The Obama administration established a benchmark of 40 percent enrollment for that age group.

"These are populations that are hard to reach and the discouraging conclusion is that whatever the administration is doing in terms of outreach is not working," Pearson said.

The federal government has not yet released demographic information specific to Florida.

This year the penalty for not buying insurance is rising to 2 percent of yearly household income or $325 per adult and $162.50 per child under 18, whichever is higher.

In total, nearly a million Floridians signed up for coverage last year.

Consumer advocates said the state would exceed that number by the end of the current enrollment period.

"We've seen steady traffic at enrollment events," said Nicholas Duran, state director for Enroll America, a nonprofit that supports signing up for coverage under the health law.

Duran said he expects a "surge" of consumer interest as the deadline to sign up approaches. "Last year we saw that more than half of the folks who signed up actually enrolled in the last month," Duran said.

About half of the people who enrolled in Florida are signing up for the first time, according to the federal data. The other half are returning customers who had coverage under the health law in 2014 but selected a new plan for next year.

"It's encouraging to see so many people being proactive and shopping around for a new plan," said Jodi Ray, director of Florida Covering Kids & Families, a program at the University of South Florida that received a $5.3 million "navigator" grant from the federal government to help consumers sign up for coverage.

Ray said it was important for people to make sure they're choosing the best option for their healthcare given the number of plans on the marketplace. There are more than 90 ACA plans available in Miami-Dade and Broward counties.

Some navigator groups said their internal data show that new customers are much more likely to seek out in-person assistance than people who signed up last year. That may mean Americans are getting used to a law that sparked outrage in some parts of the country when it was passed in 2010.

"I think that once people get into the marketplace they can see the benefits of enrolling and become more comfortable just doing it themselves," said Karen Basha Egozi, CEO of the Epilepsy Foundation of Florida, which has navigators in 35 counties.

Follow @MHhealth on Twitter for health news from South Florida and around the nation.

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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