Florida

8/15/25: See important update below re. total enrollment

Overall preliminary rate changes via the Florida Office of Insurance Regulation and/or the federal Rate Review database.

Aetna Health inc:

(Aetna/CVS announced last spring that they're pulling out of the individual market in EVERY state in 2026.)

AmeriHealth Caritas Florida:

Amerihealth Caritas Florida, Inc. (AHC) has offered comprehensive and fully insured coverage to members in the individual ACA market since 2023. AHC is filing a rate increase for 2026 products. The plans associated with this filing will be offered both on and off the Federally Facilitated Marketplace (FFM) in Florida.

Originally posted 4/19/25

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

Originally posted 3/04/25

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

Originally posted 12/22/24

Florida has over ~4.7 MILLION residents enrolled in ACA exchange plans, 97% of whom are currently subsidized. They also have an estimated ~112,000 unsubsidized off-exchange enrollees.

Combined, that's over 4.8 million people, or a stunning 20.3% of their total population. More than 1 in 5 Floridians are enrolled in ACA exchange healthcare coverage.

Originally posted 8/30/24

Florida state law gives private corporations wide berth as to what sort of information, which is easily available in some other states, they get to hide from the public under the guise of it being a "trade secret." In the case of health insurance premium rate filing data, that even extends to basic information like "how many customers they have."

If you think I'm being sarcastic, this is literally a screenshot of what you get if you attempt to use the Florida Office of Insurance Regulation's filing search:

Not content to let Georgia hog all of the state-sues-feds-over-low-income-healthcare-coverage-policy headlines, the state of Florida has also recently gotten into the act with their own federal lawsuit, this time over the Children's Health Insurance Program, or CHIP. Via Health News Florida:

Gov. Ron DeSantis’ administration has filed suit to challenge a new federal requirement that specifies when children can be removed from the state’s Children’s Health Insurance Program.

...At issue is a Biden administration rule that took effect Jan. 1 requiring states to provide 12 months of continuous eligibility for enrollees ages 18 and younger under Medicaid and CHIP, even if monthly premiums are not paid.

Originally posted 08/07/2023; updated 11/02/23

Florida state law gives private corporations wide berth as to what sort of information, which is easily available in some other states, they get to hide from the public under the guise of it being a "trade secret."

In the case of health insurance premium rate filing data, that even extends to basic information like "how many customers they have."

If you think I'm being sarcastic, this is literally a screenshot of what you get if you attempt to use the Florida Office of Insurance Regulation's filing search:

Shout-out to Jody Young for bringing this Florida Politics article by Christine Sexton my way this evening:

A ‘Nixon goes to China’ moment? Conservative Republican pushes for state Medicaid expansion.

  • 'These are not handouts. We’re not throwing money down the drain. We are helping our working class Americans get ahead.'

A conservative Florida Republican doctor who has been an ally of Gov. Ron DeSantis and his handling of COVID-19 says it’s time for the state to expand Medicaid despite the long-running opposition of GOP legislators.

...[Rep. Joel] Rudman said the loss of Medicaid coverage for hundreds of thousands of Floridians this year illustrates the need for change. A spreadsheet compiled by House Democrats shows of the 524,076 Floridians who have lost coverage in the last four months, nearly 50% are under the age of 21.

During the COVID pandemic emergency, Congress passed legislation which, among other things, required states to provide "continuous coverage" of people who enrolled in Medicaid or the CHIP program.

Normally Medicaid/CHIP enrollees have their eligibility statuses "redetermined" every month (or quarter in some states, I believe) to make sure they were still eligible for the program, but the Families First Coronavirus Response Act (FFCRA) stated that in order to receive increased federal funding of their Medicaid/CHIP programs, states couldn't kick anyone off as long as the public health emergency was in place (unless they died, moved out of state or asked to be disenrolled).

This requirement ended effective April 1st, 2023 via an omnibus bill passed back in December.

Florida

A week and a half ago, on a Saturday Night, my friend Jenny Chumbley Hogue, a Texas-based health insurance broker, gave me a heads up about a rather concerning and suspiciously-timed notice regarding Oscar Health of Florida:

BREAKING from Florida. @LouiseNorris @charles_gaba @jgmcglamery

Hello agent, please view the below information in reference to Oscar. We have received this information from Oscar and are passing it along to you.

Beginning at midnight Monday, 12/12/2022, (00:00 am Tuesday morning), Oscar in Florida will cease all new sales for IFP. All previously enrolled members and auto-enrolled members can keep their current plan by paying for January coverage. If members need to make a plan change, they need to do so by this time, midnight Monday.

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