Affordable Care Act ‘Navigators’ chart a path for Floridians who are looking to save up to thousands of dollars a year on healthcare

Posted on 05/04/21 by Dave Bruns

The coronavirus pandemic had hit the New York performing arts industry hard, so two performers from New York relocated to the Tampa Bay region in 2020 to take advantage of the lower cost of living. 

Unfortunately, they not only lost steady work, but they also found themselves without the union health insurance that formerly had been provided by the Actors Fund.

But this spring, they got good news from the University of South Florida’s Jodi Ray: Thanks to the American Rescue Plan Act (ARPA) recently passed by Congress, premiums for their Affordable Care Act (ACA) health plan were dropping from approximately $1,400 a month to $300.

“They thought it was the greatest thing since sliced bread,” said Ray, director of USF’s Covering Florida initiative, which oversees ACA Navigator organizations statewide. Navigators provide free, independent assistance to those seeking ACA health coverage. 

“Thanks to the ARPA stimulus legislation, millions of Americans age 50 to 64 stand to save substantially through lower ACA health-insurance premiums or through more favorable terms on deductibles or copays,” said Jeff Johnson, state director of AARP Florida.  

For Floridians with annual incomes of from $17,420 up to $26,130 for a family of two – or anyone who’s received unemployment compensation in 2020 or 2021, the ARPA benefits could even cut monthly health-care premiums to zero for a Silver-level ACA plan through 2022.

The biggest savings may come for Floridians with incomes up to $69,680 per year for a family of two, who could see sharp reductions in health-care premiums – in some cases, dropping from a sky-high $2,000 a month or more to half as much.

Few states stand to benefit from the new law more than Florida. First, Florida is among the grayest states in America, with the second-highest percentage of residents age 65-plus. 

Second, the Sunshine State continues to lead the nation in ACA health plan enrollment, with about 1.9 million enrollees in 2020. In 2019, enrollment topped 2 million.  

Third, because Florida lawmakers opted not to set up their own state-based online health-insurance marketplace, Floridians can take advantage of a special enrollment period running through Aug. 15 that will allow them to change plans, even if they just signed up in the regular enrollment period last fall. The special enrollment period is open to anyone using the federal health coverage marketplace, healthcare.gov.

Ray said that some Navigator offices across the state are so busy that they’re running out of available appointment times. While it’s possible to buy ACA health coverage on your own through the online federal marketplace at healthcare.gov, or through a private insurance agent, many people turn to Navigators, who make no commissions on sales and offer independent advice in free counseling sessions. 

Few groups are better positioned to benefit from the new provisions than people age 50 to 64, said Islara Souto, director of the Navigator Program for The Epilepsy Foundation, one of a network of Navigator groups working with the USF Covering Florida program. The Epilepsy Foundation serves Palm Beach, Broward, Miami-Dade and Monroe Counties.

“Typically, the higher income and higher age consumers would normally find very expensive Marketplace plans,” Souto said. “They are now seeing very much lower plans, potentially even zero-dollar plans,” she said.

It’s especially welcome relief for Floridians age 50 to 64 who have struggled with the impact of the coronavirus pandemic, said Melanie Hall, executive director of the Family Health Care Foundation of Tampa. The foundation provides Navigator assistance, focusing on Hillsborough, Pinellas, Pasco and Polk Counties.

“A lot of folks made the decision this year to take early retirement,” Hall explained. “Going back to work meant additional exposure (to COVID-19) when they weren’t ready to do so.”

Hall said she’s seen about a 30- to 40-percent reduction in monthly premiums because of the ARPA legislation. “That has been particularly helpful for the early retiree population,” she said.  “They’re getting more financial assistance as a result. You’re talking about a population that needs access to more health services, is more at risk for financial consequences of an illness, and it’s all happening in a pandemic.”

One self-employed Tampa Bay couple with incomes of about 400 percent of the federal poverty level (about $69,000 for a family of two) knew one of them would have surgery in 2021, so they signed up for a higher-level ACA plan during the normal enrollment period in late 2020, Hall said. The cost was high, about $2,100 a month.

In April, the couple discovered that their health-care premium for the same type of plan had dropped to $900 a month, Hall said.

What Hall calls “the sweet spot” is for people with incomes of 100 to 150 percent of poverty level – that is, incomes from $17,420 to $26,130 per year for a family of two, Hall said. In some areas, Floridians with incomes at this income level can qualify for Silver-level health coverage carrying a zero-dollar monthly premium.

For another Tampa Bay resident who took early retirement at age 63, a Bronze-level ACA plan’s monthly premiums dropped from $256 a month to $107, Hall said.   

To get the quickest benefit from the new law, Florida consumers should take advantage of a special enrollment period that will run through Aug. 15, the Navigator groups said.  It will benefit not only those who’ve looked at ACA coverage previously but found it too costly, but also those who signed up during the regular enrollment period in late 2020 but who now could qualify for lower premiums.

But even those who don’t get around to making changes to your coverage will see benefits at tax time, according to Joyce Case of the Health Planning Council of Northeast Florida in Jacksonville.

Because discounts under the law function as tax credits, Case said, you have a choice. You can choose to apply all or some of the tax credits to the monthly premiums now, or you can wait until you file your income taxes for 2021 early next year. If you wait, you’ll qualify for the same tax credit, but it will be applied to either reduce the income tax you owe or, if you owe no tax, to increase your tax refund. 

Here’s one more reason to check into recent changes in health-care rules under the ARPA: If you have recently left your job and are receiving so-called “COBRA coverage” – named for a federal law that lets you continue your employer-sponsored health coverage for a period after you leave your job – the federal government will pay for your COBRA plan’s premium for six months, (downloads as a pdf) from April through September 2021. If you qualify, contact your former employer’s HR department and ask them about this benefit.

“I’m excited to see that go into effect – there are so many people who fall into the coverage gap who can benefit,” Souto said. 

Finally, there are important benefits for people who received or were approved for unemployment insurance for any week during 2021. Even if their 2021 income is higher, they’ll be treated for health-insurance purposes as if their income were 133 percent of the federal poverty level, or $23,168 for a family of two. These people will be eligible for a zero-premium Silver-level health-insurance plan, Hall said.

This story is provided by AARP Florida. Visit the AARP Florida page for more news, events, and programs affecting retirement, health care, and more.

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