With more than 4 million enrollees and the deadline on Tuesday, Florida is again leading the country in the number of people who have signed up for health insurance under the Affordable Care Act.
Florida’s total of 4,034,546 is ahead of last year’s count by about 800,000, according to the federal Centers for Medicaid and Medicare Services. That was the second-largest increase in the nation, behind Texas which recorded 880,000 new plans.
A year ago, Florida led the nation in the number of enrollees through the marketplace with more than 3.2 million, an increase of more than 500,000 people from 2022, according to CMS.
Nationally, the ACA added 3.7 million newcomers for a record tally of about 20 million through Wednesday.
National projections show a quarter more Americans signed up for coverage this year compared to last — another record-breaking year when 16.3 million enrolled in the program.
CMS report: ACA marketplace national enrollment snapshot
Signs-ups spiked after President Joe Biden took office, with Democrats rolling out a series of tax breaks that give millions of Americans access to low cost plans, some with zero-dollar premiums.
Florida alone accounts for about 20 percent of the national numbers.
County breakdowns are not available yet, but Miami-Dade has historically led the country with the most enrollments.
The nation’s top health official credited piqued interest in the coverage with an aggressive campaign to get people enrolled in the ACA, also known as Obamacare. The administration has worked with nonprofits across the country, including in predominately Black and Latino communities, like South Florida, to get new people into coverage.
The administration has also invested millions more dollars into hiring navigators who help people enroll.
About 70 navigators are available in Central Florida through the Primary Care Access Network (PCAN), recorded a nearly 18% increase in new enrollees seeking plans.
Lisa Reineck, the PCAN program manager, said she wasn't surprised by the rising number of new consumers in the region.
"I think the number could grow even more. But there's clearly a need," Reineke said. "In addition to where we are economically in the country, I don't think it's surprising at all."
In addition to increased outreach and advertising, new tax credits and the expansion of immigration statuses have allowed more people to qualify for insurance, said Rebecca Sayago the PCAN executive director.
In December, the Department of Homeland Security extended the reregistration periods for the Temporary Protected Status (TPS) designations of El Salvador, Haiti, Honduras, Nepal, Nicaragua and Sudan until March 2025.
"The TPS expanded for another 24 months. That allows a lot of individuals and families to be eligible for these tax credits in the insurance marketplace," she said. "All these little bits and pieces have impacted the ability of our navigators to access more consumers in need of having a health care plan."
PCAN has navigators fluent in Vietnamese, Ukrainian, Russian, Portuguese, Creole and Spanish.
The increased enrollment has not come without cost. Millions of new enrollees have turned to the marketplace because they have been booted off Medicaid, the nearly free health care coverage offered to the poorest Americans or those with disabilities.
Roughly 14.5 million Americans have been recently kicked off Medicaid after the federal government lifted a three-year ban that barred states from removing ineligible people during the COVID-19 public health emergency.
When the emergency ended at the end of April, states began purging millions of people during an error-plagued process that has left thousands of children and pregnant women without coverage in some states.
Florida’s Medicaid program grew from about 3.8 million beneficiaries in January 2020 when the emergency began to nearly 5.78 million in April 2023. With the end of the emergency, the state has used an eligibility “redetermination” process that dropped about 830,000 people.
The redetermination process is continuing, and further enrollment decreases are expected.
The open enrollment period began Nov. 1 and ends at 11:59 p.m., but special enrollment will open starting Wednesday and will last through Oct. 31. Those who qualify for special enrolment include life-changing situations such as adopting a child, losing a job, losing insurance, or getting divorced.
To enroll or re-enroll, go to HealthCare.gov or CuidadoDeSalud.gov, or call 1-800-318-2596.
Information from the Associated Press and News Service of Florida was used in this report. Joe Mario Pederson writes for WMFE. Sherrilyn Cabrera writes for WLRN. Rick Mayer is the Health News Florida producer.
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