Health Care

In South Florida, signing up for Obamacare isn’t necessarily an endorsement

Madelaine Carrazana, 46, discuss Obamacare options with insurance agent Arturo Aguiar at a UniVista Insurance agency in the Miami neighborhood of Flagami.
Madelaine Carrazana, 46, discuss Obamacare options with insurance agent Arturo Aguiar at a UniVista Insurance agency in the Miami neighborhood of Flagami. MIAMI HERALD STAFF

The man stood up in a huff after spending half an hour of his Saturday in Hialeah reluctantly signing up for health insurance he didn’t want.

“It’s like Communism!” Pedro Fuentes said, spitting out the words after enrolling in a plan through the Affordable Care Act that would cost his family more than $90 a month.

No city in the country, when measured by ZIP codes, has more enrollments through the federal insurance exchange than Hialeah, one of the most Republican cities in America. But many of the people registering aren’t happy about it.

They don’t like President Obama. They don’t want health insurance. And they certainly can’t fathom having to pay a tax penalty for failing to get covered.

That has brought them here, to Ñooo Qué Barato (“Damn, How Cheap”), Hialeah’s best-known bargain store, where a banner by the entrance reads, in Spanish, REFORMA DE LA SALUD. Infórmese aquí. Inscríbase ahora. HEALTHCARE REFORM. Inform yourself here. Enroll now.

Fuentes, a 53-year-old trucker who lives in Miami Gardens and left Cuba two decades ago, said he doesn’t want insurance because he periodically gets physical exams to keep his trucker’s license and finds that care sufficient. Insurance should be required only of people of “a certain age,” he said — meaning older (and sicker) than him, the kind of high-risk pool that would be unsustainable to insurers without younger, healthier people.

On a more fundamental level, though, Fuentes said, the government shouldn’t mandate coverage.

“They shouldn’t force you to take it,” he said. “Where’s our freedom?”

That sentiment is widely shared in Hialeah, the Cuban-American Republican stronghold of Miami-Dade County and the largest Hispanic city in Florida. Last November, Republican Gov. Rick Scott, who won reelection despite losing in Miami-Dade by 58-39 percent, received a whopping 73 percent of the vote in some Hialeah precincts that fall in ZIP code 33012 — the one with the highest number of Obamacare enrollments in the nation. Three more Hialeah ZIP codes also fall in the top 10, which are all in South Florida.

The reason why so many are signing up is probably because so many are uninsured. There’s no city breakdown in federal data, but U.S. Census figures from 2011 show Florida has the country’s second-highest uninsured rate, after Texas. Miami-Dade, with one-third of its residents uninsured, leads the state.

The Obama administration has touted that nearly 1.4 million people have signed up for Obamacare in Florida in the past two years, more than any other state on the federal exchange. The majority, about 637,000, have enrolled in Miami-Dade. The sign-up period ends Sunday.

In a call with reporters last week, White House senior adviser Valerie Jarrett said the numbers show the healthcare law “should transcend politics or ideology.”

“That’s nothing that we should really be debating about,” she said. “The results speak for themselves.”

Yet the numbers shouldn’t be taken as a political endorsement, said U.S. Rep. Mario Diaz-Balart, a Republican whose district includes Hialeah.

“I’ve always found it kind of humorous when the Obama administration says, ‘Look at all those people that we’re enrolling,’” he said. “These are not voluntary enrollments. If you don’t enroll, you get fined.”

On two afternoons of interviews in two Miami-Dade locations this week, the looming fine was the most-cited reason among new enrollees — even when they acknowledged some benefits.

“There’s good coverage, especially for buying medication at a better price,” said 35-year-old Leonardo Gómez, a Hialeah trucker. “I had other insurance, but I’m switching to this one because it’s a little cheaper.”

Despite those savings, Gómez added flatly that Obamacare “doesn’t work.”

“No one is supposed to be forced to do something in this country,” he said. “They’re pressuring us.”

To be sure, there are eager enrollees. But some, perhaps aware of the loud opposition from their friends and neighbors, are almost sheepish to admit it. They hesitate to respond to a reporter’s questions, and do so quietly.

“My job offers me health insurance, but it’s more expensive,” said Héctor Prats, 46. The new law, he added, is “humane.”

At a UniVista Insurance agency in the Miami neighborhood of Flagami, 22-year-old Rolando Suarez enrolled with his mother, 46-year-old Madelaine Carrazana, who is unemployed.

“He did a good job with Obamacare,” Suarez said of the president. “It helps many people.”

The lingering politics of Obamacare are inescapable in Miami, where signs seemingly on every block advertise insurance-enrollment sites with the same logo the president used in his 2008 and 2012 campaigns. The “O” with a blue semicircle over red stripes has become so ubiquitous it looks like the president has reopened campaign offices all over town.

“That logo is going to become not the logo for him running for president, but the logo for the program,” predicted Bruce Turkel, a Miami-based brand consultant. Like McDonald’s letting franchisees use its golden arches, he added, “unwittingly ... the federal government has given their ‘licensees’ the tools they need to sign people up.”

The politically charged term “Obamacare,” coined by Republicans who used it derisively but eventually accepted by Democrats, has also stuck.

Douney Avila, president of World Class Insurance Group, the agency enrolling people at Ñooo Qué Barato, said he went with the more neutral “healthcare reform” phrasing on the banners he printed last year. The ones he made this year, displayed on the other side of the store, say “Obamacare.”

“If you don’t put ‘Obamacare,’ nobody knows what you’re talking about,” he said.

Avila said many of the 2,000 people his agency enrolled last year and 1,500 it has enrolled this year remain Obamacare critics, often under the mistaken impression that enrolling means obtaining public insurance. Sometimes, in protest, they ask him to quote them a price for “private” insurance outside the federal exchange — though all the exchange plans are private.

In one case, Avila recalled, coverage outside the exchange would have cost a client $800 a month — compared to $30 a month with a policy purchased on the exchange and subsidized by the federal government.

“You, to try to ‘hurt Obama’ — which you won’t — will end up paying more money,” Avila said he told the client.

The man ended up choosing the Obamacare plan, Avila said.

The warped reason? “‘To take Obama’s money away.’”

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