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How Florida overcame opposition to rise to the top of the ACA enrollment heap

UnderdogFlorida’s Republican leaders have fought the Affordable Care Act at every turn, banning navigators from county health departments, offering no state dollars to boost outreach efforts to 3.5 million uninsured and leading the fight to repeal the law. Yet the state has emerged as a tale of what went right with President Barack Obama’s health care overhaul.

More than 440,000 Florida residents had been enrolled through the federal marketplace through the end of February, putting Florida on pace to exceed the federal government’s initial projections by the time enrollment was scheduled to close March 31. This week, the Obama administration extended the deadline.

The numbers are impressive for a state where Republicans control the governor’s mansion and both houses of the Legislature. By comparison, Republican-leaning Texas has enrolled 295,000 through the federal site, even though its population is about a third larger than Florida’s.

Florida’s success is due partly to infrastructure created in the swing state by Democratic-affiliated groups during the last three presidential elections, along with continued investment by the Obama administration and nonprofit advocacy groups in the diverse state that will likely be competitive in November’s midterm election.

Groups helping customers enroll in ACA-related health plans have used many of the same people who ran Obama’s presidential campaigns, giving them five years of deeply-entrenched relationships in communities, data to pinpoint the uninsured and veteran volunteers to track them down. The state narrowly went for Obama in 2012.

April Washington, a U.S. Dept. of Health and Human Services regional government relations director who attended an enrollment drive in Miami, said Miami-Dade County leads Florida in healthcare marketplace enrollments and was the nation’s second-most enrolled county as of March 15.

“It’s because of your grass roots effort on the ground,” Washington said.

At the same event, Ray Paultre, the organizing director for non-profit Enroll America’s Florida campaign, agreed. “Miami has shown itself a model for an all hands on deck approach,”

The successes and failures of the Affordable Care Act also carry more political weight in a battleground state such as Florida where the new law will fuel election campaigns for both Republicans and Democrats, said Democratic strategist Screven Watson.

“(The Republicans) are going to use Obamacare as a hammer over the Democratic candidates in November,” he said, adding that if Florida’s enrollment numbers were dismal, it could have big implications in 2016.

“When you’re talking presidential elections, if you have Florida you win,” he said.

Florida’s Republican leaders chose not to spend any state money marketing the new health plans to millions of uninsured, so the work was supported by $20.5 million in federal grants plus manpower from the nonprofit organization Enroll America.

Florida residents have also been reached by federally funded TV, radio and digital ads. About $52 million has been spent in the last three month on the ads in Florida and the other 28 states relying on the federal marketplace, said Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services. The agency has repeatedly declined to provide a state-by-state breakdown of how taxpayer dollars are being spent on ads.

Enroll America’s Tony Penna began in 2008 as a volunteer neighborhood team leader for Obama’s campaign in Jacksonville, manning three phone banks a night. By 2012, he was a paid organizer for the campaign, overseeing neighborhood leaders and volunteers as they canvassed apartment buildings, staffed tables at community events and made nightly cold calls. Read more.  

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