Obamacare open enrollment begins . How to choose the best plan?

When Ben began studying his medical options under the Affordable Care Act, he didn’t know he had advanced cancer.

But she was alarmed when she saw blood after going to the bathroom. And after two years without insurance – he lost his job insurance when his technical job moved him to another country – the 56-year-old Miami Beach man decided it was better to find out how to get coverage through Obamacare.

He searched HealthCare.gov, but the number of forms confused him. Then he heard someone on WLRN, South Florida’s public radio station, mention the “navigators,” which help people choose the plan that’s right for them.

I told myself that was exactly what I needed, a browser,” Ben said. The Miami Herald doesn’t fully identify Ben at his request because of privacy concerns.

The navigator who spoke on the radio that day worked for Epilepsy Florida, a nonprofit organization dedicated to supporting people affected by epilepsy. The group has had a specialized program in Obamacare for years.

Islara Souto, director of Epilepsy Florida’s navigational program, said federal budget cuts have left her organization with half the workers it had last year for this work. She now has 7 navigators, instead of 12, serving Palm Beach, Broward, Miami-Dade and Monroe counties during the six-week 2020 enrollment period, which begins Friday, November 1 and ends December 15.

“Our resources are extremely limited,” Souto said. “We rely on community partners and state and local representatives to do our job, while trying to make the most of our budget to hire navigators.

But Ben said the navigators he worked with last year offered him valuable assistance in choosing an affordable insurance plan, including making sure he understood he was eligible for federal subsidies for low-income people.

The navigator helped me find a plan in which the deductible and the maximum of what I had to pay out of my pocket were the same amount, and that was something I could pay,” said Ben, who explained that his monthly premium ended up being about $100 once the subsidies were applied to him.

And that was critically important. It turns out Ben had rectal cancer and the colonoscopy he had was scheduled by the first primary care doctor he’s seen in several years.

Ben said he is concerned that criticism of the ACA by some in Congress and President Donald Trump’s administration could jeopardize medical services for people like him.

“It’s inconceivable to me that they can do that,” he said. “If I lose this service, I couldn’t afford the treatment. I’ve seen how much it costs.

One of the bills for six days of hospital admission was $120,000, he said.

In previous years, Souto said his staff had participated in health fairs and other events, delivering brochures and information, but now browsers work primarily over the phone, so they can reach more people who need assistance.

Florida remains a stronghold of the beleaguered medical services law.

The market seems to have stabilized. Monthly premiums have stopped rising after two consecutive years of increases. At the state level, the average monthly premium for a 27-year-old who does not receive federal subsidies in a so-called “silver plan” cost about $391 last year, and that figure is projected to drop to $383 by 2020, according to the Centers for Medicare & Medicaid Services (CMS).

Nationally, the premium price for a 27-year-old with a household income of 150% the federal poverty level who qualifies for federal subsidies would be $52 in a silver plan, compared to $374 without the subsidy.

Those who earn more than 400% of the federal poverty level do not receive subsidies and face high costs. The federal poverty level in 2019 is $12,490 per year for an individual and $25,750 for a family of four.

Moraly Arroyo, who works for the Florida Health Justice Project, a non-profit organization in Miami, said that people who earn more than 400% of the federal poverty level often work in service industries or construction, and sometimes have more than one job.

“We don’t take into account the fact that these same people who provide these services and work very hard don’t have access to basic medical services because they have to choose between paying the premium, paying the rent and putting food on the table,” Arroyo said.

Nationally, monthly premiums have dropped an average of 4% by 2020, CMS reported last week.

The number of Floridians enrolled in Obamacare plans through Healthcare.gov who paid their premiums increased from 1.46 million in 2018 to 1.76 million in February 2019, according to information released by CMS. Ninety-five percent of Florida enrollees receive government subsidies, one of the highest rates in the country, the statistics show.

But there are still significant gaps in coverage. Until 2018, some 2.7 million Floridians, about 13 percent of the state’s population, were uninsured, according to the most recent figures from the federal Census Bureau, an increase of about 52,000 people compared to 2017.

Ben, the former Miami Beach technical clerk, said although he still suffers constant pain from cancer, he is very happy that the insurance will pay for his treatment.

“I don’t wish it on anyone, it’s terrible, and I can’t imagine what someone would do without health insurance,” he said. “If I don’t have access to [the services of the] Affordable Medical Services Act, to Obamacare, with advanced cancer … What do you do? Die?”