Time’s running out to get insurance or lower premiums under Obamacare
As the COVID-19 delta variant leads to record hospitalization levels throughout Central Florida, advocates are warning the 300,000 residents of Orange, Osceola, Seminole and Lake counties who lack health insurance that they have just days left to sign up for coverage during a special enrollment period of the Affordable Care Act.
And tens of thousands of others who are already enrolled may be able to dramatically lower their premiums.
Aug. 15 is the final day to apply for 2021 health insurance available through the Health Care Marketplace (HealthCare.gov), the private insurance option of what is often called Obamacare. Due to the ongoing pandemic, Congress has temporarily increased subsidies for individuals, lowering the costs of most plans.
And in February, the Biden administration reopened the enrollment window — normally held toward the end of each calendar year. Since then, more than 400,000 Floridians have signed up, leading all other states in new enrollees.
“With the cost of hospitalization for COVID treatment estimated to average $73,300 for uninsured patients, it is urgently important that people be covered as soon as possible,” said Kimberly Brown, a spokeswoman for Florida Blue. “And many uninsured individuals are eligible for an ACA health insurance plan for no monthly premium — zero.”
That’s a result of the $1.9 trillion American Rescue Plan, signed into law in March, which provides funds that will lower or eliminate premiums, deductibles and copays. With the subsidies, an estimated four out of five enrollees will be eligible for plans that cost $10 a month or less.
In addition, anyone who received unemployment benefits at any time in 2021 is eligible to be insured with no premiums for the remainder of the year.
“This is a once-in-a-generation investment that responds to the historic challenges facing our country, including our young Americans,” said State Sen. Shevrin Jones, D-Miami Gardens, speaking at a recent news conference to urge Floridians to enroll. “So please, tell your friends and family members … and let them know this is an opportunity we cannot afford to let pass us by.”
The new pandemic-era rules also remove income limits for financial assistance toward individually purchased plans. Now, the amount anyone pays for such a plan can be no more than 8.5% of their income.
“People whose income was near 400% of poverty level [roughly $100,000 for a family of four] may see some of the largest changes,” Brown said. “They previously may have only qualified for a small subsidy. Now, their monthly insurance payment could be cut in half.”
However, subsidies are not generally available to people who can get health insurance through their employers.
For everyone else, subsidies for current enrollees are retroactive to the beginning of this calendar year. They can also be claimed as tax refunds when people file their 2021 tax returns.
If you already have a Marketplace plan, log in to update your application and enrollment. Your new eligibility results will show you the extra tax credit amount. You may be able to choose a plan with lower out-of-pocket costs for the same price or less than what you’re currently paying — but note that your yearly deductible, if you have one, may start over, meaning whatever you’ve already paid won’t count.
At a minimum, all plans offered in the Marketplace must cover emergency services, hospitalization, pregnancy and maternity care, mental health and substance abuse counseling, prescription drugs, rehabilitative care for people with chronic conditions or injury, laboratory services, preventative and wellness visits and pediatric care.
“This is not politics,” said Sean Shaw, founder of the nonprofit advocacy group People Over Profits and a former Florida state representative. “This is sometimes … the only thing between financial ruin and bankruptcy and someone’s ability to take care of a sick family member.”