By
Anne Swerlick
|
August 6, 2017

1.2 Million Floridians are at Imminent Risk of Losing the Subsidies That Make Their Health Coverage Affordable

This post was last updated on September 29, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

The Administration is threatening to discontinue funding for insurance cost-sharing, which helps low- and modest-income Floridians afford health care. If funding stops, Florida will take the biggest hit.

This is a critical, high-risk moment for Floridians who rely on government subsidies to afford their health insurance. Under the Affordable Care Act (ACA), cost-sharing reductions (CSRs) help people with low and modest incomes afford out of pocket expenses such as deductibles and co-payments.

The Administration is threatening to abruptly cease payments for CSRs. This uncertainty is having an immediate impact on the insurance market, and insurance companies are getting more and more skittish about their continued participation in the ACA marketplace. Those that intend to stay predict substantial premium rate hikes.[1]  A Kaiser Family Foundation analysis projects that the average premium for a Florida benchmark silver plan under the ACA would increase 25 percent.[2]

Floridians have the most to lose. Consider these facts:[3]

  • 1.2 million Floridians receive cost-sharing subsidies through the marketplacemore than any other state.
  • The average subsidy is $1,204 annually per qualifying enrollee.
  • The total amount of CSR subsidies flowing to Floridians in a year is $1.5 billion.

Also, Florida taxpayers could be on the hook for billions in additional dollars because premiums will increase. While the federal government would save money by not making CSR payments, it would face increased costs for tax credits that subsidize premiums for marketplace enrollees with incomes 100 percent to 400 percent of the poverty level.[4]

The Administration’s unwillingness to guarantee the vital funding needed to stabilize and reinvigorate the marketplace under current law appears to be a direct extension of the failed attempts to repeal and replace the ACA.

This is not the leadership that struggling Florida families need to ensure ongoing access to vital health care services and financial peace of mind. We urge policymakers to provide a firm guarantee of continued funding for CSRs.

Notes

[1] Letters from Molina and Anthem to Congressional leaders, April 27, 2017. Accessed at: https://www.manatt.com/Insights/Newsletters/Manatt-on-Health-Reform-Weekly-Highlights/Manatt-on-Health-Reform-Weekly-Highlights-May-2?utm_source=healthreformnewsletter&utm_medium=email&utm_campaign=hr_5.2.17#Article2

[2] Kaiser Family Foundation Analysis, Estimate: Average ACA Marketplace Premiums for Silver Plans Would Need to Increase by 19% to Compensate for Lack of Funding for Cost-Sharing Subsidies, Kaiser Family Foundation, 2017. Accessed via: http://www.kff.org/health-costs/press-release/estimates-average-aca-marketplace-premiums-for-silver-plans-would-need-to-increase-by-19-to-compensate-for-lack-of-funding-for-cost-sharing-subsidies/

[3] Lueck, S., Interactive Map: Cost-Sharing Subsidies at Risk Under House GOP Health Bill, 2017. Accessed via:  http://www.cbpp.org/blog/interactive-map-cost-sharing-subsidies-at-risk-under-house-gop-health-bill

[4] Levitt, Larry, et. al., The Effects of Ending the Affordable Care Act’s Cost-sharing Reduction Payments, Kaiser Family Foundation, 2017. Accessed via: http://kff.org/health-reform/issue-brief/the-effects-of-ending-the-affordable-care-acts-cost-sharing-reduction-payments/

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