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Why Florida set a record in ACA signups for 2024. And how you can still enroll

Woman hands health insurance card to doctor
Most Floridians had until Jan. 16 to enroll in a health plan on the Affordable Care Act marketplace, but some residents can still sign up.

Florida and the nation broke records for signups. Expanded financial assistance and the ongoing Medicaid unwinding contributed to the spike.

Florida once again leads the nation in signups for health plans on the Affordable Care Act marketplace, with more than 4.2 million residents enrolling during the open enrollment period that ended earlier this month.

That’s about one million more than last year, according to the latest update from the Centers for Medicare and Medicaid Services.

Several factors contributed to this year’s record-high enrollment in Florida and in the U.S., where 21.3 million consumers overall had signed up for coverage as of Jan. 24.

Enhanced subsidies first offered during the coronavirus pandemic and then extended through 2025 as part of the Inflation Reduction Act made it more affordable for some families to sign up for health plans.

This expanded assistance, offered in the form of tax credits to help pay for monthly premiums, allows people already eligible for aid to get more help and extends eligibility to some middle-income families.

“People want accessibility to care, people are interested in ensuring that they're living healthier lifestyles and that they have access to services that are going to help them to do so,” said Xonjenese Jacobs, director of Florida Covering Kids & Families.

The group, based out of the University of South Florida, helps people navigate the health insurance market.

Medicaid unwinding plays a role

Jacobs also attributes the recent rise in enrollment to stronger investment in raising awareness about marketplace plans. She said consumers seem more confident about signing up for coverage when they contact navigators for help.

“It’s truly a testament to how much work has been done on the ground between the marketing, the navigators and just communication about the need to have health insurance,” said Jacobs, who has a doctorate in public health.

The increase in ACA signups also comes as states redetermine Medicaid eligibility for the first time since the pandemic began. The federal government had barred states from dropping people’s Medicaid coverage regardless of whether they still qualified during the pandemic, but that protection expired last spring.

Hundreds of thousands of Floridians have lost their Medicaid coverage since the state resumed the renewal process. Jacobs said many residents who no longer qualify for Medicaid have been able to move over to Obamacare plans.

Others may still qualify for Medicaid and lost coverage for procedural reasons, such as not responding to renewal requests or facing administrative barriers. Navigators are helping these families get back on Medicaid or access other forms of low-cost care through county-run assistance programs or federally qualified health centers, said Jacobs.

Ways to get help accessing coverage

The federal government has established an extended special enrollment period for people who lose Medicaid coverage during the unwinding, so impacted Floridians can still sign up for marketplace plans even though open enrollment has ended.

Other residents may also qualify for special enrollment. Some qualifying life changes include getting married, changing jobs or moving, among other factors.

You can learn more about special enrollment periods on HealthCare.gov.

You can get in touch with navigators who can help you sign up for health insurance plans by visiting CoveringFlorida.org or calling 877-813-9115.

I cover health care for WUSF and the statewide journalism collaborative Health News Florida. I’m passionate about highlighting community efforts to improve the quality of care in our state and make it more accessible to all Floridians. I’m also committed to holding those in power accountable when they fail to prioritize the health needs of the people they serve.