Florida Trend | Florida's Business Authority

Buying Obamacare health insurance in Florida

FLORIDA TREND sought to find out how much a lower-middle income person could expect to pay for Obamacare coverage in 2019. To get price quotes on the federal Healthcare.gov platform, we used a hypothetical single, 35yearold nonsmoker with no children and an annual income of $35,000.

  • Notable: Where you live makes a big difference — the number of available plans varies from county to county. Only one insurer, Florida Blue, offers coverage in all 67 counties. Residents of Seminole County have the most choices — 106 plans from six insurers. Flagler and Volusia counties each have 91 plans available, followed by Brevard County, with 89.
  • Notable: Many of the plans seem unaffordable for low and middle-income workers. The cheapest plans typically have the least coverage with the highest deductibles. In Orange County, the average bronze plan, the cheapest plan type, costs $247 a month and has an annual deductible of $6,703.
  • Notable: Florida’s most rural counties have the fewest choices but the lowest prices, thanks to big premium tax credits. In 19 counties, Florida Blue is the only insurer selling Obamacare coverage. The company’s offerings include four bronze plans with monthly after-subsidy premiums of between $11 and $46.
  • Notable: Making sense of the differences between plans takes some patience and a basic understanding of insurance terms and concepts. And even then, picking the right plan can be difficult. “I have a Ph.D. in this stuff, and I find it complicated,” says Steve Ullman, a health policy expert at the University of Miami.
  • Notable: Premiums and deductibles aren’t the only factors to consider. For example, one of the cheaper plans in Miami costs $215 a month and comes with a $6,650 deductible, but it also charges an after-deductible coinsurance fee of 40% for an E.R. visit and a $35 copay for generic drugs (up to an annual out-of-pocket maximum of $7,900). It’s no wonder so many young, healthy people choose to not get insurance, Ullman says. “If I’m looking at that, I say, ‘well, I’ll just go bare.’ ”

Ullman adds that the lack of appeal of these plans, especially after the repeal of the individual mandate, threatens to undo the early coverage gains made under Obamacare. “The younger, healthier people are not signing up for insurance, and what you’re left with is a pool of older, sicker people,” he says. “That drives up the cost of health insurance and prices people out of the market.”

Source: Healtcare.gov, FLORIDA TREND research


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