With a week to go before the March 31 deadline to sign up for health insurance under the Affordable Care Act, South Florida enrollment efforts have surged.
Organizers from elected officials to religious institutions are marshaling one last campaign to cover as many eligible consumers as possible. An army of volunteers and federally funded and trained counselors have fanned out across Miami-Dade, setting up shop in community rooms, public parks, local churches and health centers, hosting enrollment drives and health fairs nearly every day.
At the Calle Ocho street festival in downtown Miami, a Liberty City health fair and the 93rd Street Community Baptist Church in West Little River, ambassadors for Obamacare have been signing people up for health insurance in South Florida.
Miami-Dade leads all Florida counties in sign-ups and has the nation’s second-highest enrollment rate among counties, according to April Washington, a regional government relations director for the U.S. Department of Health and Human Services who attended the Liberty City enrollment drive.
“It’s because of your grass roots effort on the ground,” Washington said. “Your elected officials understand that helping people get insured will [ease the burden on] city services.”
Enrollment drives are scheduled right up to deadline day, part of a national push to reach the HHS target of six million people.
A wave of new sign-ups on the exchanges — nearly 800,000 during the first two weeks of March — drove enrollment nationwide to more than five million people since Oct. 1, HHS reported. Visits to healthcare.gov, the once-troubled online portal for the federal exchange, also have risen, as have the numbers of consumers who called the toll-free line (800-318-2596) for help.
The Obama administration long predicted a late surge in enrollments as the deadline neared, and federal officials have campaigned relentlessly during the home stretch to March 31. First Lady Michelle Obama, HHS Secretary. Kathleen Sebelius and others also have stepped up personal visits to states considered key to the success of the ACA, including Florida, Ohio and Texas.
And HHS has released dozens of short videos promoting consumers’ personal stories under the slogan, “Get Covered,” while government-sponsored TV commercials have emphasized sports injuries — an effort to reach younger consumers — as a reason to sign up for health insurance.
Florida, with the second highest rate of uninsured residents in the nation, leads all 36 states in sign-ups on the federally run exchange, with more than 442,000 people selecting a health plan, and an additional 124,000 assessed eligible for Medicaid.
Many, such as Makiesha Victor, 20, bought health insurance for the first time.
“I didn’t know anything about health insurance,” said Victor, a server at a McDonald’s restaurant. “I feel good knowing I’m covered. Before, I felt I couldn’t see a doctor.’’
Victor signed up at a Liberty City health fair inside the Belafonte TACOLCY Center, a local health clinic, where University of Miami medical students and federally trained counselors helped consumers find coverage.
Residents lined up hours before the center’s gates opened for free medical services that — for some residents — may be the only healthcare they receive all year. They came for prostate and cervical cancer screenings, mammograms and tests to gauge everything from cholesterol levels to bone density.
And they got something more. About 15 federally trained enrollment counselors helped consumers understand their options for coverage under the health law and whether they qualified for financial aid to buy a private health plan or for Medicaid, the state-federal health program for the poor and disabled.
Even with time running out to enroll, some consumers remained undecided.
“I was putting it off,” said Artiium Mohammed, 29, of Northeast Miami-Dade.
Mohammed said he tried to enroll on healthcare.gov soon after open enrollment began Oct. 1 but gave up after running into technical problems with the website.
“Sad to say, with rent and student loans to pay, health insurance wasn’t the first thing on my mind,” he said. He said his employer doesn’t offer insurance. He left the fair without making a commitment.
At the 93rd Street Community Baptist Church on a recent weeknight, federally trained enrollment counselors from local health centers waited to help consumers like Charlene Eford, 23, of Miami, who came to the sign-up with grandmother Betty Brown, 60.
Eford, an office assistant, wanted to enroll in a health plan for the first time in her life, at Brown’s urging.
“I raised her as a newborn baby. Naturally I’m concerned,” Brown said.
“They gave you a tax credit,” Rachelle Desamours,a federally trained counselor, told Eford.
Desamours, who was working with the nonprofit group Catalyst Miami, told Eford she qualified for government assistance of $160 a month to pay for the health plan she chose, a silver-level Deluxe Preferred Medical plan that will cost her $33 a month after financial aid. Eford also bought a dental plan for $9.99 a month.
“You want the cheapest plan,” Brown advised her granddaughter. “You got other bills, baby.”
Karina Valdivia, 32, an uninsured single mother of two young children, signed up at the 93rd Street church, too.
Valdivia, who lives in Miami’s Brickell area and works for a cleaning service six days a week, found a silver-level plan that she said will cost her $21.36 a month in premiums.
“I can afford it now,” she said, a surprised tone in her voice. “I thought it was going to cost more, but it was less.”
Not everyone who sought help found a good deal on health insurance, though.
A Miami man named Henry, who wouldn’t give his last name, left the 93rd Street church enrollment drive unhappy about his lack of eligibility for financial aid, which is available to those earning between one and four times the federal poverty level, which ranges from $11,670 to $46,680 a year for a single person.
“It’s not affordable any way you look at it, but it’s necessary,” the 55-year-old man said of his health plan options, which started at $350 a month.
The health law’s eligibility criteria for financial aid to buy health insurance has created a love-it-or-hate-it response among consumers, said Eduardo Herrera, an enrollment counselor with Community Health of South Florida, a federally qualified health center.
“Everybody has the same reaction,” Herrera said. “Either they’re really pleased, or if they don’t qualify for the subsidy, not pleased.”
He added that many consumers who earn too much to qualify for financial aid are opting out of coverage.
“They would rather pay the penalty,” he said, which for 2014 will amount to $95 or 1 percent of annual income, whichever is higher, per eligible individual.
But Herrera and his fellow counselors say interest remains high. They no longer take lunch breaks because of the numbers of people waiting to enroll.
“It’s been crazy. Each of us is registering 17 to 20 people a day, way up from before,” Herrera said.
Jason Conner, who manages enrollment efforts at Miami’s Borinquen Medical Centers, said the nonprofit recently hired three temporary workers and opened a new location to handle the last-minute consumer interest.
Conner said his staff helps about 190 people a day and enrolls about 60 of them — a 40 percent increase over February.
“About half the people we see qualify for Obamacare, but there’s a good 30 percent who fall into the gap,” Conner said, referring to those whose household incomes are too high for Medicaid and too low for subsidized healthcare under the health law.
Those individuals will qualify for a hardship exemption from the health law’s individual mandate, which requires eligible Americans to enroll for coverage or pay the penalty.
An estimated 765,000 Floridians fall into the coverage gap, according to the Kaiser Family Foundation.
As enrollments nationwide surpassed the 5 million mark, those working to educate and enroll consumers say they have learned lessons for future South Florida efforts.
“Miami has shown itself a model for an all-hands-on-deck approach,” said Ray Paultre, the organizing director for nonprofit Enroll America’s Florida campaign.
Enroll America already is thinking ahead to next year’s enrollment campaign, Paultre said. But first, he said with a hint of exhaustion: “I’m going to take a nap for three days.”
This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.