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Update: Individual Health Insurance Landscape in Florida

Update: Individual Health Insurance Landscape in Florida

Posted Oct 03, 2014 by Jenifer Dorsey

In 2014, Florida defaulted to Obamacare’s federally facilitated health insurance exchange, HealthCare.gov, and opted not to expand its Medicaid program. The state recently made headlines when it was reported that some of its doctors were refusing to accept patients with exchange-based health insurance plans.1

Below is a roundup of Florida’s exchange enrollment numbers, carriers on and away from HealthCare.gov, and a look toward 2015.
 
Latest Florida health insurance enrollment numbers
A total of 983,775 Floridians selected individual health insurance plans through the federally facilitated exchange during open enrollment (Oct. 1, 2013, and March 31, 2014) and through the special enrollment period that ended April 19,2014.2
 
According to HHS data3:

  • 1,603,575 Floridians were eligible to enroll in a Marketplace plan
  • 1,114,877 were eligible to enroll in a Marketplace plan with financial assistance
  • 180,479 were determined or assessed eligible for Medicaid/CHIP
  • 983,775  individuals selected a Marketplace plan

These numbers only account for those Floridians who selected health insurance through HealthCare.gov and does not account for those who purchased private health insurance away from the exchange.

2014 Medicaid expansion in Florida and the coverage gap
Florida was not among the 27 states, including Washington DC, that expanded Medicaid to people below 138 percent of the federal poverty level in 2014. In Florida, the Medicaid adult income eligibility limits as a percent of the federal poverty level are as follows4:
 
Parents of dependent children (in a family of three)

  • As a share of poverty – 35 percent
  • As an annual income limit – $6,809

Other adults (non-disabled; for an individual)

  • As a share of poverty – 0 percent
  • As an annual income limit – $0

An estimated 763,890 poor, uninsured nonelderly adults in Florida—27 percent of all uninsured nonelderly adults in the state—fall into what is known as the coverage gap5. Their incomes were too high for Medicaid eligibility but below the lower limit exchange-based premium tax credits, according to the Henry J. Kaiser Family Foundation. Across the United States, an estimated 5 million poor adults fall into this coverage gap, and 16 percent of them reside in Florida6. Texas is the only state with more and accounts for 22 percent (a fifth) of those who fall into the coverage gap. Georgia was third with 9 percent7.
 
Florida health insurance carriers on and off the exchange
When looking at the list of health insurance carriers on the exchange and in the private marketplace, it might appear that Floridians may select from several plans and carriers. However, the Orlando Sentinel reported, “more than half of Florida’s 67 counties will have only one or two insurance companies selling plans through the new marketplace. No county will offer plans from all 10 [carriers].”8 In 21 rural counties, Blue Cross Blue Shield is the only carrier option.
 
Florida’s 2014 federally facilitated exchange carriers9

  • Aetna
  • Ambetter from Sunshine Health
  • Cigna Health and Life Insurance
  • CoventryOne
  • Florida Blue (Blue Cross and Blue Shield of Florida)
  • Florida Blue HMO
  • Florida Health Care Plans
  • Health First Insurance
  • Humana Medical Plan
  • Molina Healthcare of Florida
  • Preferred Medical Plan

Florida’s 2014 private marketplace carriers (off the exchange)10

  • Aetna
  • AvMed Health Plans
  • Cigna
  • Coventry Health Care
  • Coventry Health Plan of Florida
  • Florida Blue
  • Health First Insurance
  • Humana
  • Humana Health Insurance Co. of Florida

Carriers selling health insurance in Florida, on and off the exchange, are subject to change in 2015. On June 27, 2014, the Tampa Bay Times reported that “about a dozen” health insurance companies had filed paperwork to sell plans in Florida on the federal exchange.11 This included returning insurers such as Aetna and Cigna, as well as new participants such as United Healthcare.
 
Will 2015 rates increase in Florida?
Not all insurers have disclosed their 2015 rates, and speculation looms that premiums will increase. Kaiser Health News reported in late July that a top executive from Florida Blue, which insured more than 1 in 3 Florida residents through the exchange in 2014, said many in the state could experience rate hikes in 2015.12 According to Kaiser Health News, Florida Blue CEO Patrick Geraghty indicated this was due to several factors including a lack of young, healthy enrollees and an influx of older and sicker enrollees. The article stated, however, that only Humana and Molina have disclosed their 2015 Florida rate proposals. Humana would increase rates an average 14.1 percent for its HMOs and an average 2.2 percent for its PPOs. Molina’s rates would decrease an average of 11.6 percent across all its plans.
 
In June 2014, CNBC and others reported that when filing paperwork for 2015, six insurers entered zeros in the space where they were to report proposed rate change percentages.13 These companies will not necessarily keep their rates the same; according to CNBC, they claimed the information is a trade secret.
 
How can Floridians who missed 2014 open enrollment get health insurance?
There are some options outside open enrollment. Visit HealthCare.gov or contact a health insurance agent to determine whether or not you qualify for a special enrollment period in which you may enroll in health insurance that qualifies as minimum essential coverage.
 
If you do not qualify for special enrollment, you may consider a temporary health insurance plan until you can begin ACA-compliant health insurance coverage in 2015. Visit healthedeals.com to learn more about temporary health insurance options, get a quick quote, and apply and enroll within a few minutes—coverage begins as early as the next day.
 
While temporary health insurance plans are not ACA-compliant and will not prevent you from owing a tax penalty, they do offer short-term health insurance benefits—as few as 30 days—to help pay for unexpected medical expenses.
 
Call 888-839-7679 to talk to a healthedeals.com health insurance agent about your temporary health insurance options, as well as your individual health insurance options on and away from the state-based and federally facilitated exchanges.
 
A SHORT TERM HEALTH BENFIT PLAN IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD.  THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.


1 Chang, Daniel. “Some Florida Doctors Decline to Accept Obamacare.” The Miami Herald. July 12, 2014.
2 U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation. “Health Insurance Marketplace: Summary Enrollment Report for the Initial Annual Open Enrollment: For the Period: October 1, 2013–March 31, 2014 (Including Additional Special Enrollment Activity Reported through 4-19-14).”  May 1, 2014.
3 Ibid.
4 The Henry J. Kaiser Family Foundation. “The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid.” April 2, 2014.
5 Ibid.
6 Ibid.
7 Ibid.
8 Jameson, Marni. “More Details Emerge on Florida Health Insurance Exchange.” Orlando Sentinel. Aug. 12, 2013.
9 Helibrunn, Evi. “Florida Health Insurance.” U.S. News & World Report. Last updated July 12, 2014.
10 Ibid.
11 Tillman, Jodie. “Insurers File to Sell 2015 Marketplace Health Plans in Florida, Rates Still Not Known.” Tampa Bay Times. June 27, 2014.
12 Galewitz, Phil. “Florida’s Biggest Health Insurer Signals Rate Hikes Ahead.” Kaiser Health News. July 21, 2014.
13 Mangan, Dan. “No Obamacare Sunshine: Florida Rates Still Secret.” CNBC. June 25, 2014.

Jenifer Dorsey is a freelance writer whose specialties include health and fitness, wellness, sports and recreation. She is a competitive amateur track cyclist who also enjoys mountain biking, hiking, camping and other outdoor adventure. Jenifer received a B.A. in journalism from Columbia College Chicago and is an MFA candidate at Naropa University. She lives in Colorado.