Health care for some, help for adults who need insurance

by Diane Dimperio

Every year it gets worse! Politicians elected to represent the citizens of Florida are following the agenda provided by the doners who fund their campaigns. In return for their likely re-election our lawmakers are governing according to the dictates of wealthy conservatives. One glaringly consistent Republican policy has been its virulent antagonism toward the Affordable Care Act (ObamaCare). When the ACA first passed into law in 2010, the negative messaging by Mitch McConnell and his cronies was effective in turning people against it but over the decade it has been in place families have seen the benefits and attitudes have shifted. There are many benefits of the Affordable Care Act (ACA) but the best known is improved access to health insurance for adults between 19 and 64 years of age. The ACA envisioned two options to make health insurance affordable. Medicaid, which has no cost to participants, was to be available for very low-income adults and, people with low and moderate incomes could purchase subsidized insurance through an online portal called the “Marketplace.” Two issues interfered with the implementation of the ACA. Insurance offered through the Marketplace was put in the hands of private sector insurance companies, which are profit driven, and were more expensive than many could afford. Then the Supreme Court made Medicaid Expansion (MedEx) optional so states were free to accept or reject it. Many Republican dominated states initially rejected it but now only 13 states, including Florida, have denied its citizens access to this life saving health coverage. 

The rejection of MedEx during the 2021 Legislative session was especially horrendous. The economic and health consequences of the pandemic created a perfect storm of devastation for many of our residents. Data from the scientific literature and the experience of other states prove MedEx improves the financial and health status of participants, communities and state economies. In addition, the Biden administration even sweetened the deal by offering an extra $3.5 billion in federal funds to Florida if our legislators would expand Medicaid. But the Republicans, who control the legislative process, had their orders from their out-of-state masters, and ignored program benefits and survey data showing the majority of both Democrats and Republican voters support expansion. They shamelessly rode roughshod over attempts by the Democrats to pass enabling legislation. 

The only good news for uninsured adults comes from the American Rescue Plan Act (ARPA). This Act, developed and passed by the Biden Administration, offers a safety net for millions of Floridians. The Administration is doing what it can, within the law, to make insurance offered through the Marketplace more affordable. The ARPA increases subsidies that reduce the monthly premium. For example, an individual making between $13,000 and $19,000 and a family of four making between $26,500 and $39,000 are eligible to enroll in a “Silver Plan” with no monthly premium. The Silver Plan offers comprehensive coverage and lower co-pays than other choices. The ARPA also increases subsidies for people with higher incomes. Everyone who is eligible to apply for a Marketplace plan will find insurance is more affordable. For example, a single person making $30,000 will pay $85 per month instead of $195 and a family of four with an income of $50,000 will pay $67 per month instead of $252.

Adults with very low incomes, less than $12,880 for a single person or $26,500 for a family of four, are not eligible to enroll in the Marketplace unless they received unemployment in 2021. Anyone who received unemployment benefits in 2021 can enroll in a Marketplace plan with no monthly premium until, at least, the end of this year. 

The Biden administration has also opened Marketplace enrollment and will accept applications until August 15, 2021. To help people make decisions on a complicated issue, the Administration has restarted the Marketplace Navigator Program. Navigators offer free, personal, one-to-one counseling to help people understand what plans they are eligible for and how much they cost. When learning about plans be sure to ask about deductibles and co-pays. Navigators can also tell you which doctors are enrolled in which plans. If you, your friends or family, are unable to afford health insurance you/they can go to or call the Suwannee River AHEC Navigator program at 386-230-9400. They can help you find out what you are eligible for and how much it will cost. 

In addition to increasing the subsidies for health insurance, the ARPA has added funding for community-based services like Federally Qualified Health Centers and Behavioral Health. So, if you cannot qualify for insurance through the Marketplace, call around to see if the services you need are available directly from the providers like Meridian Behavioral Health. 

The Biden administration has done what it can to help uninsured Floridians gain access to health care. We know their policy experts will be thinking of ways to help improve access to health care for the hundreds and thousands of Floridians who are not eligible for Marketplace plans and still in need of health care.

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