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Activists begin Florida Affordable Care Act effort

10:09 AM, Sep 3, 2013   |    comments
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WASHINGTON (News-Press) -- With nearly 4 million Floridians lacking health coverage, the Obama administration and advocacy groups are hustling to sign up hundreds of thousands of uninsured residents under new health exchanges set up under the 2010 health care law.

Activists are knocking on doors, manning phone banks, attending community meetings and handing out information to prepare eligible Floridians for Oct. 1, when, according to the current schedule, they can log into the exchange online to compare health plans and find out which plan best meets their needs.

"People aren't going to go the marketplace unless they know about it, and that's been the core focus of our work - making sure people know what's coming," said Nick Duran, Florida director of Enroll America.

The nonprofit organization, which has deployed workers in 10 states with high concentrations of uninsured Americans, is setting up shop at pharmacies, community health clinics and churches where they hope to find uninsured Floridians eligible - and eager - for coverage.

But those efforts are getting little support from a state government that has become a national symbol of opposition to Obamacare, officially known as the Patient Protection and Affordable Care Act.

Florida was the lead plaintiff in the unsuccessful lawsuit challenging the law's constitutionality.

Initially, GOP Gov. Rick Scott opposed expanding the state's Medicaid program under the law, He later changed his mind, but the Republican-controlled state Legislature rejected that expansion, which would have added some 1.1 million to the rolls of the insured.

That makes the health exchange the most significant tool to help people gain coverage in a state where nearly one-quarter of everyone under 65 lacks health insurance, according to recently released Census Bureau figures. Only Texas has a higher share of uninsured.

More than 123,000 of Lee County's 471,610 residents under 65 - or 26.2 percent - lacked insurance, according to 2011 census data. More than 67,000 of Collier County's 235,342 nonelderly residents (28.6 percent) did not have coverage either, according to the data.

The exchanges are designed to serve small businesses and people who don't have access to insurance through an employer or aren't enrolled in a government program such as Medicare.

More than 900,000 Floridians buy insurance on their own. Hundreds of thousands more - most of whom currently lack insurance - could enter the individual market through the exchange.

Enrollment will continue through the end of March.

Under the 2010 law, beginning in 2014 most people will have to have insurance or pay a penalty. Those who get insurance through the exchange are eligible for a subsidy if their incomes fall between 100 percent and 400 percent of the federal poverty level - about $24,000 to $94,000 per year for a family of four.

In Florida, more than 6 million residents fall into that range and would be potentially eligible for assistance.

Insurers have submitted their proposed rates and the federal government is expected to finalize them in September. Plans in Florida will be offered at four different levels of cost-sharing - bronze, silver, gold and platinum - along with a catastrophic plan for those under 30.

Florida Insurance Commissioner Kevin McCarty warned consumers in July they could see premiums rise an average of 35 to 40 percent under the law.

But health reform advocates say it's impossible to compare current plans to ones that will be offered under the Affordable Care Act because new plans will have to offer more coverage, such as maternity care and prescription drugs, than existing ones usually do.

Premium costs also don't represent what people will actually pay, because of federal subsidies.

In general, women and older and sicker consumers are expected to benefit from lower premiums while younger, healthier and male consumers are expected to have higher premiums.

In addition to potentially being eligible for subsidies, those facing higher premiums may also get help with out-of-pocket costs through lower deductibles and cost-sharing limits.

Florida could have opted to run its health care exchange. Instead, state officials turned away millions in federal planning money and decided to let federal regulators take over.

Florida is one of 27 states, most of them controlled by Republicans, that have left management of the online marketplaces completely up to Washington.

Thanks mainly to federal grants, about 200 trained "navigators" in Florida will be certified to help people in every county understand their options, what they can afford, whether they qualify for a federal subsidy and how to sign up for insurance through the exchange.

In contrast, Maryland, which has about 800,000 uninsured residents - a fifth of Florida's total - has about 500 trained workers to help with enrollment. Maryland is running its own exchange.

Scott and other Florida officials have raised privacy concerns about the navigators, saying they would have access to sensitive records of people trying to enroll and won't be properly trained to safeguard such information.

But health reform advocates say no one will have to provide personal health information.

Most of the state's navigators are being hired and trained through the Covering Kids & Families coalition through the University of South Florida in Tampa, an organization that's spent many years signing up families for public assistance, said Laura Goodhue, executive director of the consumer advocacy group Florida CHAIN.

Health reform activists say misguided concerns over privacy and cost could further slow the already daunting task of enrolling Floridians confused about the law and unaware of the exchange.

A national poll conducted for the independent Kaiser Family Foundation found that 51 percent of respondents say they don't know enough about the health care law to understand how it will impact them and their family.

The sentiment was higher among the uninsured (62 percent). The poll also found that only one-third say they've heard "a lot" or "some" about the health exchange in their state.

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