Question: I own two homes in two different states (California and Florida) - and I live at each one 50% of the time (this is how I file my California State Income Tax - Florida has none). Which state health exchange do I purchase? How can I ensure that I am able to see Doctors in both states?
Answer: (1) It sounds like you probably are not going to be eligible for a subsidy based on income, if so there is no reason to enroll through the exchange in either state. (2) The best way to get access to in-network providers in both states is to purchase a Blue Shield of CA plan or a BCBS of Florida plan that will provide access to the “Blue Card” which is the BCBS national coverage plan. At no extra charge, it will allow you to get in-network coverage in both states. Anthem Blue Cross in CA will not honor the Blue Card for individual ACA-compliant plans.
Your state of residency is generally determined by where you file your income tax returns.
The other solution is to purchase a PPO plan or an HDHP and establish an HSA and fully fund that account every year. An HDHP-compliant PPO would probably be the best of both worlds and both states.
Health insurance is probably lower cost in CA than in FL, so you may have shot yourself in one foot by establishing residency in FL to avoid CA personal income tax.