Health care signup faces rocky road

Enrollment workers must scramble to reach millions uninsured in state

WASHINGTON Less than five weeks from the start of a massive health insurance enrollment campaign, Florida faces a daunting task.

A small army of paid “navigators” and volunteers remains unorganized, untrained and unclear about just how to sign up the one in five Floridians who are uninsured.

And a slow start, as well as lack of cooperation from state officials, have only made the enormous task even more challenging.

By all accounts, the 3.5 million uninsured Floridians are mostly unaware of how to enroll in plans— and even the requirement that they do so by Jan. 1, when the Affordable Care Act takes full effect.

“We’ve got a lot of work to do in fiveweeks,” said Robert Bertisch, executive director of the Legal Aid Society of Palm Beach County, which was awarded a federal grant

of $446,783 and will hire five navigators to help people sign up. “I hope it’s enough time. If this doesn’twork, I’m concerned a little bit about the future of affordable health care. We need to get these people insured.”

Republican opposition to Obamacare prompted state leaders to refuse to create a state-run online marketplace for buying insurance, leaving the task to Uncle Sam. And Gov. Rick Scott and Attorney General Pam Bondi complained this week that the program has insufficient safeguards to protect consumers’ personal information.

Leaders of the enrollment campaign say they can overcome these obstacles, promising extensive and creative ways to reach out to Floridians, not only about the insurance requirement but also about the federal subsidies that will help them buy coverage.

But their plans to convey information at “back to school” and other community events this summer — buttressed by radio ads and social media messages in English, Spanish and Creole — remain largely unformed. Their task could become even greater if some employers decide to drop their insurance plans, whichwould widen Florida’s big gap in coverage.

Thefirst deadline is Oct. 1, when federal officials must go live with an online “exchange” that will offer an array of pre-approved health insurance policies as well as calculators to help individuals and families determine their eligibility for tax credits and other subsidies. As yet, though, the website isn’t up, and rates for the policies haven’t been determined.

Meanwhile, paid “navigators” and volunteers who are supposed to reach out to uninsured people and help them sign up must be vetted, trained and equipped.

The grass-roots campaign is intended tomake people aware of the need to buy insurance and explain new benefits, including tax credits, leading into an open enrollment period from Oct. 1 toMarch.

“We have to first make sure our team on the ground reflects the communities they are working with,” said Nick Duran, who grew up in Coral Springs and serves as Florida director of Enroll America, a Washington-based group charged with overseeing the signup effort. “We do have a staff that speaks Spanish and Creole and already has been working in these communities.”

In Florida, 36 percent of nonelderly Hispanics and 28 percent of non-elderly African-Americans are uninsured, according to Census data from 2011. Though undocumented immigrants are ineligible for benefits under the law, the state is also home to tens of thousands of legal immigrants, speaking a variety of languages.

A staff member who appeared on a Haitian radio show in Miami received 20 phone calls within an hour from consumers wanting to learn more, Duran said. He acknowledged, however, that “most who would benefit [from the new law] don’t knowwhat’s coming.”

Enroll America has hired 27 staff members in Florida, who are enlisting and training volunteers.

Federal officials, meanwhile, passed out $7.8 million in grants two weeks ago to eight groups in Florida, some with partners across the state, who will hire and train the navigators to canvass neighborhoods and help people enroll. The navigators and volunteers will be going to churches, social service offices, day-labor centers and clinics— wherever the uninsured can be found.

They may be knocking on your door, offering help to fill out forms or enroll online. You may encounter themat local pharmacies, where they will pass out leaflets touting the benefits of the Affordable Care Act. Or you might see them at information tables near the entrance to discount stores.

“We’re kind of like Girl Scouts selling cookies to people going in and out,” saidDawn Steward of the Healthy Start Coalition of Orange County, who has experience signing up families for Florida’s KidCare program.

“We are looking forward to the opportunity — a little scared, because everything is coming along awfully fast. Everything is on fast forward,” she said. “We want to make sure the Hispanic community is covered, because that’s the highest uninsured population that we knowof. We willwork theHaitian community, and every community. We will go first of all to high-need areas.”

She also hopes to persuade companies to insureworkers or at least give them information about buying policies. The Obama administration has delayed for a year a requirement that companies with more than 50 employees provide insurance or pay a fine.

“It’s a win-win for corporations and for my families to have information in their HR packets,” Steward said.