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MIAMI (CBSMiami) – Open enrollment begins Thursday for those who purchase health insurance through the federal marketplace.

Last year Florida led the nation in sign-ups for the Affordable Care Act with approximately 1.7 people selecting a plan on healthcare.gov.

As they did last year, the Trump administration and Republicans in Congress are still trying to dismantle the ACA.

Some nine million to 10 million people currently have private plans through the ACA’s government-sponsored markets. More than 8 in 10 receive subsidized premiums and are cushioned from rate increases. Federal help paying premiums is still available despite GOP efforts to repeal the health law.

At Community Health of South Florida, the ACA led to a drop in the rate of uninsured patients from 70 percent to 50 percent.

“Once they got coverage, they were able to come a lot more often. With closer follow-ups, have better control of their diseases,” said Dr. Abiona Redwood.|

The law’s popularity has bounced back from a low in 2013 and is a major topic for voters. Three out of four Floridians say it’s very important to their vote.

The clinic is located in Florida’s 26th District which is represented by Republican Carlos Curbelo. Despite the numbers, he and his fellow Republicans argue premiums are rising too fast and a GOP plan would have been better.

“They would be part of a healthcare system that is more coherent and we would be on a more sustainable path towards better healthcare in our country,” he said.

Democrats disagree and point to Republicans attempts to repeal and replace the ACA.

“They’ve cut the budget for advertising for the open enrollment period dramatically. So we need to get the word out that it is still alive and well,” said Rep. Debbie Wasserman Schultz.

The former Chairwoman for the Democratic National Committee wants to get the word out about the open enrollment period citing her personal experience as a breast cancer survivor.

“One day I was the picture of health. The next day I was a cancer patient. So you never know. It can hit you out of the clear blue sky,” she said.

Decisions made at the ballot box could determine the future of healthcare in our country. But for now, people are required to sign up for insurance or face a fine.

Open enrollment lasts 45 days (Nov. 1st until December 15th). You can signup at Healthcare.gov.

2019 Enroll Quick Reference Guide

If you need help with the process Click Here or call 1-800-318-2596.

People who had marketplace insurance in 2018 are automatically re-enrolled if they don’t actively re-enroll by December 15 into their same or similar plan. If that old plan is no longer available, they will be enrolled in another plan with a different insurance company. These people will need to pay their premium for January in order for this coverage to begin.

The marketplace sent notices to those people that were automatically re-enrolled. While automatic re-enrollments keep you covered, there are new affordable plans for 2019 that may better fit a person’s needs.

Similar to Medicare’s Open Enrollment Period, people who miss the deadline to enroll in a plan of their choice will not be able to make any plan changes until the next coverage year unless they qualify for certain Special Enrollment Periods.

People whose issuer isn’t offering their plan in 2019 are eligible for a Special Enrollment Period due to losing coverage and have the opportunity to choose a different plan.

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