In less than three months, uninsured Floridians will be able to purchase medical insurance online under a new federal health law. Making sure average citizens understand how it works will be a Herculean task accompanied by a massive marketing blitz promoting the biggest expansion of the social safety net since Medicare.
Hundreds of thousands of Florida residents making less than $48,000 a year will be eligible for federal money to help purchase their own insurance through online health exchanges under the Affordable Care Act. The new marketplaces, which are open for enrollment this October, will have the feel of an online travel site where individuals and families can compare different private insurance plans.
Health insurers will spend millions on ads pushing their plans and the federal government is also launching a multi-million dollar campaign, targeting libraries, gyms and concerts. Health clinics and non-profits will also be joining the advertising mix.
That means Florida residents are about to get hit with a ton of information designed to walk them through the enrollment process, but the feds and insurers must also find a way to package the information so it doesn't end up confusing residents even more.
"People are a little bit intimidated - not knowing what to expect, not knowing what the outcome will be - but the resource will hopefully allay some of the fears," said Renard Murray, a regional administrator with the Centers for Medicare and Medicaid Services.
The federal government's marketing strategy includes everything from door-to-door walks, working with churches, partnering with local mayors and a massive social media presence, including phone apps, Facebook, Twitter and Flickr campaigns.
Recently, Murray was wrapping up a presentation for students at Florida International University in Miami, one of nearly a dozen presentations he'd done over three days, along with a half dozen media interviews.
In Broward County, state Rep. Richard Stark is working with several other lawmakers on a campaign to help educate and enroll residents. Stark, who is also an insurance agent, is already getting calls from confused constituents and insurance clients.
"All these people started saying, 'I thought I didn't have to do anything, that I would just start getting Obamacare," said the Weston Democrat.
Seventy-eight percent of uninsured adults don't know about opportunities that will be available to them in 2014 under the Affordable Care Act, according to Enroll America, a nonprofit group sponsoring a national campaign that includes home visits and passing out brochures at farmers markets and churches.
But breaking down the law is complicated. Here are just a few reasons why:
Individuals will be required to either have health insurance from their employer or purchase it and will pay a roughly $100 penalty next year if they don't. Anyone making less than $48,000 a year we will receive a voucher from the federal government to help pay the premium. The less a person makes, the more the government will pay. Anyone making below the poverty line, $11,490 for an individual or $23,550 for a family of four, won't be eligible to buy insurance through the online marketplace because they already receive Medicaid.
Adding to the confusion, the federal government still hasn't released which insurers are offering plans and how much premiums, co-pays and deductibles will cost under those plans. The rates will likely come out in September.
The Republican-led Florida Legislature, which has been reluctant to implement the new health law, decided to let the federal government run the state's online marketplace and isn't spending any additional money on marketing and outreach. The state left it up to the federal government, which gave $8 million to Florida agencies, mostly county health departments and non-profit organizations, for marketing. It spent another $5.8 million for so-called "navigators," counselors trained to help people compare plans.
Borinquen Health Care Center in Miami plans to hire some navigators and outreach staff, but still hasn't received the $256,000 grant it's been awarded. The new navigators have to be certified, but the feds haven't laid out the details of that process yet.
"We're trying to get ready but we don't know exactly what we're getting ready for. It's sort of a waiting game. It's a little frustrating, but at the same time I'm hopeful," CEO Bob Linder said. He estimates 1,200 of the 28,000 patients they treat annually may take advantage of the marketplace.
Insurers are also waiting for the government to certify their plans under the highly regulated exchange.
"Normally for a lift of this size we would be in testing mode and we wish we were and were working out kinks with the federal government," said Doug Bartel, a spokesman for the not-for-profit Florida Blue, the largest domestic insurer in the state, which will offer several plans through the exchange.
For insurers, the online marketplace marks a distinct change in the way they conduct business as they begin selling directly to consumers. Foreseeing such changes, Florida Blue opened a stand-alone store in 2006 where residents could talk to someone face to face. Executives say the 11 stores, which are sleek yet warm, uniquely position them for the exchange.
"Health insurance is really intimidating so we're trying to take some of the confusion out of it through face to face engagement," said Bartel.
The insurer is also experimenting with onsite clinics staffed by primary care doctors at two stores in Pensacola and Polk County.
Despite the media hype and the looming October deadline, critics fear the federal government won't be ready. Republicans point to the Obama administration's recent decision to delay the business mandate as a sign that implementation is fraying.
"We did Medicare Part D a while back and people said that it couldn't be done...it can be done and it will be done. Our systems are ready. We feel that our supports and other things will be up and running...the website, the call center," Murray said.