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Florida Matters: Year 2 of Enrollment on HealthCare.gov (LISTEN)

Dec 17, 2014

It's the second year of enrollment for health insurance plans under the federal health law on HealthCare.gov, the website that Floridians, and people in dozens of other states, use to shop for health insurance.

As of Dec. 15, we have passed a key deadline, the deadline to buy a plan to have coverage that starts Jan. 1. But open enrollment runs through Feb. 15, 2015, and we have gathered a panel to talk about what consumers be doing now if they still need to get health insurance coverage to comply with the federal health law known as Obamacare.

Our panel includes Mary Shedden, the editor of Health News Florida at WUSF, and Jodi Ray, the project director for Florida Covering Kids & Families at USF. Ray's navigator team can be reached by phone at (813) 803-0628.

They start by discussing the case of a St. Petersburg man who enrolled in a plan in 2014, but had to start the process over again for 2015, after his insurer told him his plan would no longer be available. 

CRAIG KOPP: Jodi Ray, your group Covering Kids and Families is in every Florida county helping people to sign up to Healthcare.gov. What are you hearing from the navigators who are walking people through the process of signing up for a healthcare plan? How many people out there are experiencing something similar -- having to pick a new healthcare plan this year?

JODI RAY: I would say it’s sort of a mixed bag. I mean a lot of people did get plans they were very happy with and they were able to retain those plans. Some people are even saying that they’re getting better prices because they’re updating their information for 2015. Some people are choosing to pick a new health plan. They’re making choices that are healthcare driven choices. I may need a particular doctor, I may need a particular hospital. So some of those are driving people to make different choices around their health plans.

KOPP: Yeah, last year it was this website isn’t working. This year people are through that. Now they’re actually using the website to find an insurance plan that may, I guess, better suit their needs?

RAY: Correct. And you know the neat thing about the website is that they’ve got this piece on the website where people can go in, consumers can go in, enter in some basic information, and they can peruse the plans now.  So they can get a really good idea of what plans are out there, and what the networks are and they can actually do a little homework on their own for those that are pretty savvy to get some information before they meet with an assister or they can do it on their own.

KOPP: Mary Shedden, what happened to this guy in St. Pete? Why do plans disappear? He had to pick a new one because his plan didn’t exist anymore.

MARY SHEDDEN: Well a lot of the insurance companies that have put plans on Healthcare.gov, they’re learning the ropes too. They’re tweaking exactly what they’re offering, they’re changing premiums in some cases – higher premiums, lower premiums. And in this case of this individual, his company chose not to offer the exact same plan in Pinellas County for the coming year. So that’s one thing that’s really important and I keep hearing over and over again is that individuals that have these plans – don’t assume it’s going to be exactly the same for next year. It’s exactly the same for a lot of us who may have employer-based or job-based plans. It’s likely your insurance is going to change for next year so you should check it out.

KOPP: Jodi Ray, I guess people who are not familiar with having health insurance, perhaps having health insurance for the first time, haven’t been through with what those of us who have been under employee plans for a long time have experienced. It seems to change every year.

RAY: Right. And we’ve seen – and I think it’ll be a while before we, you know we’ve been through this a few more times where you see people become more informed about the idea of having health insurance and using health care through health insurance. So we certainly have seen a lot of folks who have never had health insurance, they’ve never accessed care utilizing healthcare coverage. So their expectations are different than ours, their experiences are different because they don’t know what that looks like, because we have years of doing that.

KOPP: What if your insurance is charging a higher premium, and now you look at that and say well that doesn’t fit in my budget, but we have passed that December 15th deadline now. Can you still make changes?

RAY: Yeah, so the good thing is that open enrollment goes through February 15th. So folks will have an opportunity through the whole open enrollment period to update their information for the 2015 information and make decisions about the plans. Once the December 15th deadline had passed, those changes will not take effect January 1st but they can certainly get them in by January 15th to take effect February 1st.

KOPP: How many people in the state of Florida took advantage of Obamacare, got signed up last year, Mary?

SHEDDEN: Estimates are about one million and actually Florida is one of the largest states to actually sign up folks on the federal exchange and folks in programs like Jodi’s really were a big part of that. This coming year the federal government set a big target of about 9.1 million individuals signing up for insurance. That’s a huge number, but still about somewhere in the 15-20 percent of Americans still don’t have health insurance.

KOPP: Now the big draw here is that you can possibly qualify for tax credits which lower the expense of health insurance. That’s the whole key to getting this program going. How do you find out whether you qualify?

SHEDDEN: It’s really based on how much you make, and the whole point of Healthcare.gov was set up, it was set up to provide a place where folks who didn’t have access to healthcare through a job, for example, or couldn’t afford a plan can go and shop and look for a plan and then get assistance based on their annual income. So, for example, if you’re a family of four, and you make just under 24,000 dollars a year anywhere between there and if your family makes about 95,000 a year you can get some form of assistance in terms of subsidies and that’s going to help you on your monthly premiums. There’s still gonna be other costs. There’s gonna be a co-pay when you go to the doctor’s office, there’ll be deductibles to help cover, say, a cast on your kid’s broken arm. Those things are still going to exist but the subsidies and the tax credits help in terms of that monthly premium.

KOPP: Jodi, what’s the one thing that people who have not had insurance, when they get involved with this or trying to figure out what is available to them under Obamacare, what’s the biggest surprise to them when they try to sign up? Is it that they’ve got co-pays? What is the thing that shocks people most of confuses them the most?

RAY: Well, there’s, in terms of the surprise, I think more often than not I’ve seen, and I think our navigators have seen, is the surprise on folks’ face when they find out once the cost-sharing and the tax premium credits are applied what they can get health coverage for. Most people that apply get some kind of financial assistance and I think they’re really surprised what they can actually get with that assistance, that financial assistance. I think the thing that’s most confusing, especially when you’re dealing with people who haven’t spent a lot of time dealing with health insurance, is trying to understand the language of what health insurance is. Things like co-insurance, co-pays, deductibles, how well those fit into your out of pocket in terms of making a financial decision about choosing a health plan.