Nearly 1 million Floridians signed up for a health plan through the Affordable Care Act's insurance exchanges during the six-month enrollment period that ended March 31, federal health officials reported Thursday
Florida's Obamacare enrollment numbers were the highest of all 36 states using the federally run insurance exchange, and No. 2 in the nation behind California, which operates its own exchange and signed up 1.4 million people.
Of the 983,775 people in Florida who selected a private health plan through the exchange, about 91 percent or 893,655 received financial aid to pay for it, according to the report issued by the U.S. Department of Health and Human Services.
Nationwide, nearly 8.1 million people selected a plan under the ACA's insurance exchanges, and an additional 4.8 million Americans received coverage through Medicaid and the Children's Health Insurance Program.
Rep. Joe Garcia, a South Florida Democrat, said the numbers bear out the demand for health coverage in the state -- a need, he added, which could be addressed if legislators were to expand eligibility for Medicaid, the
state-federal health program for the poor and disabled, as originally envisioned under the ACA.
According to the HHS report, an additional 223,000 Floridians signed up for Medicaid during the six-month enrollment period -- bringing the state's total for the program to slightly more than 3.3 million people.
Julie Bataille, communications director for the Centers for Medicare and Medicaid Services, which administers the federal insurance exchange, attributed Florida's high enrollment numbers to a strong enrollment effort by government, private insurers and the nonprofit community organizations.
Other highlights of the report: 55 percent, or 538,000, of Florida enrollees are women. Nearly half, or 448,000, are between 45 and 64. About one third, or nearly 309,000, are younger than 35. And the great majority, about 73 percent or 722,000, chose a silver-level plan that covers 70 percent of medical costs.
Thursday's report offered information for the first time about the race and ethnicity of those who selected health plans. However, those figures were incomplete, reflecting only those who signed up through the federally-run exchange and who chose to answer optional questions about race and ethnicity.
About 31 percent of all enrollees did not report their race or ethnicity, or chose "other," according to the report.
Of the 69 percent or roughly 3.7 million who did answer the question, 62.9 percent or 2.36 million identified as white, 16.7 percent or 627,000 as African American and 10.7 percent or 401,700 as Hispanic.
Of the 555,596 Floridians who reported race and ethnicity, about 53 percent or 297,000 are white, 19.8 percent or 110,000 are African-American and 19.2 percent or 106,000 are Hispanic.
The number of Hispanics appears particularly low, considering a report in February that found Florida has about 1.1 million uninsured Hispanics eligible for either financial aid or for Medicaid.
Mayra Alvarez, associate director HHS's office of minority health, emphasized that the data for Hispanics is "a snapshot" and does not reflect those who signed up in the 14 states with their own insurance exchanges, including California and New York, which have large Hispanic populations.
Still, Alvarez acknowledged, federal health officials learned "valuable lessons" about reaching out to Hispanics during the past six months.
"The Latino community does have some unique challenges," she said, "not only with the concept of health insurance and educational challenges that we had to overcome. There are also specific concerns around immigrant families, and mixed-status families, and what information would be used."
Thursday's report also shed light on how many consumers signed up in the last month. In more than a dozen states, enrollment doubled in March, with some of the largest surges in Texas, Florida and Georgia.
Nationwide, nearly half of all enrollees, or about 3.8 million people, signed up in March, though the final tally includes consumers allowed to choose a plan through April 19 because they were "in line" when the deadline arrived or they reported a qualifying "life change."
The ages of those who signed up -- about 34 percent, or roughly 2.7 million are younger than age 35 -- is of particular interest to insurance companies. Analysts have said the younger group will help spread the risk of health coverage across a broader pool, and possibly help to hold down premium rate increases.
The Congressional Budget Office projected about 40 percent of enrollees need to be between 18 to 34 to sufficiently offset the expected costs of insuring older adults.
Mike Hash, director of HHS's office of health reform, said most analysts report enough so-called "young invincibles" entered the market to keep rates in check.
Another factor that might affect premiums is the gender breakdown, given that younger women typically are more expensive to insure than younger men, though that dynamic is inverted later in life.
Among the total 8 million enrollees, HHS reported, 54 percent are female and 46 percent are male.
Despite all the new information, some questions remain unanswered: How many of those enrolled have paid their first month's premium, required to activate a plan? And how much medical care do they need?
Bataille said there is no public data to verify how many exchange enrollees have paid their premiums, and Hash said there is no reliable measure of how many were previously uninsured.
Despite the unknowns, the Obama administration's top health official, HHS Secretary Kathleen Sebelius, who announced in April she will step down, declared victory for the president's signature domestic legislation.
"Because of the Affordable Care Act," she said, "more than eight million Americans now have the peace of mind knowing their coverage can't be taken away when they're sick and won't run out just when they need it most. They can't be denied because of a pre-existing condition or charged more because of their gender."