In 2015, the Sunshine State did it again, surpassing enrollment projections and beating out much-larger
Despite an uninsured rate among the top five highest in the country,
Experts point to a variety of factors that, combined, likely elevated the state's numbers. Using enrollment specialists that spoke a variety of languages helped bridge cultural and language divides to enroll specific groups such as the large pool of uninsured Hispanics. Small businesses jumped into the Obamacare field by selling policies alongside groceries and bill-paying services. And the
Cashing on Culture
Just after sunrise on a January morning earlier this year,
One woman spoke up, offering a phone number for her brother who did not have insurance.
"When I get to work tomorrow, I"m going to give him a call. He needs his preventative care," Jessie Trice health counselor
During the ribbon-cutting for
Outreach efforts like the one at
"The message was being put out so much more and it was in the languages that people needed to hear it in," said
That kind of personalized approach seems to have worked.
At the end of enrollment, the
"Inside a check cashing place in
But healthcare has a way of cutting across politics -- especially when it's your own.
"The realization is that the ACA has many many different aspects to it," said
Its high uninsured population is partly powered by its large Hispanic population. Many Hispanics have historically worked in industries that don't offer employer coverage, leaving many uninsured. And the economy overall is largely based on the tourism, service industries and small businesses, which are less likely to offer health insurance, said
Those who did have coverage before the ACA, Snaith said, may have lost it when employers learned about the law's requirements that insurance offer broader coverage.
Those who are under 65 and don't qualify for
"The early retirees, that is one of the demographic groups that is especially benefited by the exchange subsidies," said
He said another factor, and probably the most obvious, is that people signed up because their health demanded it.
The top 10 Miami-Dade County ZIP codes in enrollment exhibited higher rates of hospitalizations due to diabetes, hypertension and heart failure when compared to the county's other ZIP codes, according to Miami Matters, a site created by the
The reality is that we [in
An Uncertain Future
Ullmann said he expects the penalty for failing to enroll in coverage, which in 2015 is the greater of
"I'm a strong believer in incentives," he said. "So you adjust the incentives and you watch the behavior change."
In 2016, the penalty will be
But Herrick, of the
Many, Herrick added, chose the cheapest plans which came with high deductibles, or the amount paid out of pocket before insurance kicks in, making access to anything beyond preventative care expensive.
"They may well find out that they don't have the care they thought they had," and drop out of the market, he said.
What's more, the subsidies that make insurance affordable are threatened by a
King v. Burwell challenges a line in the ACA stating that only consumers who purchase coverage through an exchange established by the state, and not the federal government, will get financial assistance with their monthly premiums.
According to the
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