MIAMI - With just 48 hours until the launch of one of the key components of the new federal health law, hundreds of health counselors and volunteers are fanning out across the state, knocking on doors, working phone banks and manning tables at concerts and sporting events to tell people how to sign up for health insurance under the Affordable Care Act.
Susan Greene and Debra Leflore canvassed apartment complexes in West Palm Beach on Saturday for the nonprofit group Enroll America ahead of the scheduled launch of online health insurance marketplaces on Tuesday. It's not an easy job. It's humid, some people are rude and the language barrier in the largely Haitian neighborhood often makes it difficult to have an in-depth conversation, yet they persist.
Greene tells 54-year-old Joel Entienne that she has some information for him about affordable health coverage. It's unclear how much he understands, then suddenly his eyes light up.
"Obamacare?" he asks eagerly and ushers her inside when she nods yes. He yells for two other women, also Haitian immigrants, both employed and without insurance, to join them.
Entienne earns $16,000 a year working for the school district, but can't afford the insurance plan offered by his employer. Greene tells them they may qualify for government subsidies to help them pay for their insurance and urges them to visit healthcare.gov on Tuesday. That's when residents can go shopping for the first time on the insurance marketplaces that are at the heart of President Barack Obama's health care reforms. Floridians will also finally learn how much premiums, co-pays and deductibles will cost under the tiered system. More than 100 plans will be offered in Florida's marketplace, although prices will vary depending on where you live and residents in about 20 counties will only have one insurer to choose from.
Tuesday's rollout comes after months of buildup about the marketplaces as advocates and critics wait to see how efficiently the process, especially the technology, will work in real life.
In a potentially significant delay, the administration told Hispanic groups last week that the Spanish-language version of the website will not be ready to handle online enrollments for a few weeks. That could be especially problematic in Florida, where nearly 580,000 Hispanics are eligible for health coverage through the marketplace. In the Miami area alone, two-thirds of uninsured residents are Hispanic, according to federal health officials.
Volunteers have their work cut out for them in Florida, which boasts one of the highest uninsured rates in the country. Roughly 3.5 million people lack coverage, and the Republican-led Legislature and governor are reluctant to implement portions of the reform also referred to as Obamacare. State officials recently banned counselors from entering county health departments to help sign people up for health insurance. But perhaps the most difficult challenge will be bridging the information gap, with a large swath of the population still unaware of what the law really means. Seventy-eight percent of uninsured adults don't know about opportunities that will be available to them in 2014, according to Enroll America.
Twenty-two year-old Ketsia Denasty, of West Palm Beach, has heard about the health care law, but says she doesn't know much about it, other than "it's mandatory." People who don't have health insurance will face fines under the law.
"How does it work? When I sign up for Obamacare, will it come out of my check?" she asks, giving the volunteers her phone number so they can follow up with more information later. Denasty works in sales for a satellite dish company, but does not have health insurance. She'd like to go to the doctor soon because her wrist has been hurting lately.
On Tuesday, trained counselors known as navigators will help people like Denasty sign up for coverage in-person during a roughly 30-minute process.
Navigators must complete 20 hours of training, pass a comprehensive test, undergo a background and fingerprint check and get a state license - a lengthy process that takes several weeks.
The Epilepsy Foundation of Florida is planning to hire and train 50 staffers plus 50 volunteers as navigators. So far, 30 staffers in 35 counties have passed the test but only eight have been certified.
CEO Karen Egozi says they won't all be certified by Oct. 1, but she's optimistic, saying "at least we'll have some to get started." She sent a letter to the state Friday, urging them to expedite the process.
Anti-Obamacare groups are also targeting Florida, hitting up college campuses and tailgate parties outside NFL and college football games. Americans For Prosperity is sending out volunteers three days a week door to door in some Orlando neighborhoods with the message that the Affordable Care Act is not affordable.
"We're urging them to call their senators and congressman to repeal the bill or exempt them just like they've exempted companies and special interests," said Slade O'Brien, the Florida director for the conservative group.
Doctors are also using their platform to educate patients. Dr. Mona Mangat, a St. Petersburg immunologist, helped mobilize more than 500 Florida doctors and medical students under Doctors for America.
"Everyone's gotten of tired of the politics of it and they just want to understand it. When you sit down and talk about it in a non-threatening, non-political fashion...patients are hungry for the information."
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