The Affordable Care Act Year 3: Open Enrollment Has Begun

Nov 4, 2015

Credit healthcare.gov

It’s time to think about your health insurance again. Open enrollment for policies under the Affordable Care Act is now underway, and there are people ready to help you navigate your way through the system. 

"We're there to provide education, interpret the language of insurance, and then help consumers make a decision that best fits their financial needs and their health care needs."

Patricia Maxwell is an organizer with the Epilepsy Foundation of Florida. She is also a navigator, helping people sign up for health insurance under the Affordable Care Act. Along with other groups like Pensacola’s 90 Works, The Epilepsy Foundation now has teams of health insurance navigators across the state.

Maxwell says since the troubled roll out of the web site two years ago, the system is working well. "I don't think anybody's going to deny that there were some glitches that first year. Last year, honestly, I was on the computer quite a bit with consumers  and I did not encounter one problem getting on [to healthcare.gov], nor did I have any problems if I needed to call the marketplace for any additional assistance." 

And though Maxwell and her team work through the Epilepsy Foundation, their services are open to anyone. The foundation was given a grant and now has Affordable care Act navigators in many Florida counties. And the county you live in is important. "The insurance plans for each county in the state of Florida are going to be different. So the same plans that are available in Escambia County or Santa Rosa County may not be the identical plans that are available in Broward County."

That means if you’ve moved in the past year you may have to go through the sign up process again. There are other reasons to reapply for insurance. Cory Brown is a navigator with the Pensacola based non-profit 90 Works, which is in its third year of being ACA navigators. "Everyone's a year older, they may have a change in income (so) they need to do the application again to see if they qualify for any more or less tax credits." 

And those tax credits are the key to making this insurance affordable. Cory Brown recalls a case of a woman working at a local retailer from the first year of the affordable care act. "The policy for her was going to run about $575 a month. And she qualified for enough tax credits that her policy (ended up costing her) $35 a month."

Of course not everyone will find a deal like that and not everyone will be able to get insurance. The Florida legislature once again refused to expand Medicaid in the state, so some people will fall in what’s called the Medicaid gap in coverage. Patricia Maxwell says she frequently meets with customers who have little to no income and do not pay income taxes. "I think a lot of people believe that the Affordable Care Act is free insurance. But it isn't. It's a tax subsidy towards your health insurance premiums to make that insurance affordable. So you do have to have some reportable income." Maxwell says for people who fall in that gap, the best she can do is give the client the locations of free clinics in the area.

However if people do qualify and still go uninsured, there will be fines to pay. And those fines are getting larger. The penalty last year was $395 for an adult and $187 for children. This year that goes up to $695 for adults, $347.50 for children or 2.5% of your household income, whichever is higher.

Open enrollment for health insurance under the Affordable Care Act continues through January 31.