As federal tax penalties loomed for adults who failed to purchase health insurance, the number of uninsured non-elderly Florida adults ages 18 to 34 dropped by 9 percentage points between 2015 and 2016, a newly released report shows.
That decline fueled an overall 4-percentage point decline, from 17 percent to 13 percent, of uninsured adults in Florida, according to estimates released this month by Enroll America, a non-profit, nonpartisan organization formed in 2010 to help promote enrollment in what's commonly known as Obamacare.
But as President-elect Donald Trump and a Republican-dominated Congress prepare to fulfill campaign promises to repeal the Affordable Care Act after Trump's Jan. 20 inauguration, no one knows whether 2017 will mark the final year that the uninsured rate drops.
This year, more adults signed up for coverage during the first month of open enrollment compared to 2015.
In November, 514,580 Florida consumers enrolled in a health insurance plan, compared to 444,711 in November 2015, according to data released by the federal Department of Health and Human Services. During the entire three-month enrollment period last year, 1.7 million Florida residents signed up for coverage on the ACA marketplace — most among the 37 states using the federal exchange.
Dec. 15 is the enrollment deadline for consumers who want to have their 2017 coverage begin on Jan. 1. Open enrollment is scheduled to run until Jan. 30 for coverage that will begin after Jan. 1.
Fears that Obamacare as we know it will end after 2017 has likely boosted initial sign-up numbers this year, said Allan Baumgarten, an independent analyst who produces annual health market reviews for several states.
"I would think the risk that subsidized coverage will dry up in 2017 is a powerful incentive to sign up for coverage — and use it at the beginning of the year," Baumgarten said. "It is not unlike the stories I read of gay couples planning marriage for later in 2017 or 2018 and moving that up out of fear that the new administration will somehow undo the Supreme Court ruling [legalizing same-sex marriage]."
Cliff Eserman, a health insurance broker based in Wilton Manors, said he's been enrolling more clients in part because people want to make sure they receie the care they need before they lose federal tax subsidies that has made insurance affordable to them. "A lot of people are very fearful this year," he said.
Still, the Trump election doesn't explain the decrease in the percentage of young people without insurance between 2015 and 2016. That was when the fine for not carrying health insurance increased from $325 or 2 percent of income to $695 or 2.5 percent of income.
Katie Vicsik, Enroll America's Florida director, said enrollment assistant organizations honed in on young adults at colleges, universities and workplaces, telling them, "'You're going to pay [an average] $105 a month and here's what you're going to get or you're going to pay this fine,'" she said.
The decline in the uninsured rate among adults ages 18 to 34 was 9 percent in Broward and Miami-Dade counties and 10 percent in Palm Beach County, Enroll America's estimates show.
A reluctance among young, healthy adults to sign up for health insurance in the Obama era, even with the tax penalty, has been cited as a major reason premiums have risen and several large major insurers have stopped participating. Not enough young people are paying premiums to offset greater-than-expected health care consumption by older, sicker people, analysts have said.
And despite the progress over the last year, the uninsured rate remains higher among Florida's 18-to-34-year-olds [14 percent] than in the three age groups spanning ages 35 to 64 [12 percent to 13 percent], the Enroll America data shows.
Mark Cherry, principal analyst with health care industry analyst Decision Resources Group, said other factors in the overall decrease among the uninsured include creation of the state's Medicaid Managed Care program in 2013, which has increased Medicaid enrollment by nearly 700,000, and an overall rise in awareness of health insurance driven by marketing and word of mouth.
Baumgarten said the increase in millennials in the risk pool is good news — "since a better balanced pool should result in better financials for the insurers and lower premium increases in future years."
He noted he feels "a little optimistic" about the ACA's future because "the complexity and consequences of dismantling are daunting" and "some significant and influential groups are going to work hard to protect what is in place — health insurers, pharma companies, and provider systems."