As March 31 nears, navigators work to sign more up


CEO of WellFlorida Council, Jeff Feller, left to right, Masters of Public Health student Blosmeli Leon, an intern for the College of Public Health and Health Professions, and Allyson Hall, associate professor of Health Service Policy, discuss Health Insurance Marketplace enrollment during an Affordable Care Act information event held at the College of Public Health and Health Professions at the University of Florida to a small group of reporters and students, marking the fourth anniversary of the law's passing, Tuesday, March 18, 2014 in Gainesville, Fla.

Erica Brough/The Gainesville Sun
Published: Wednesday, March 19, 2014 at 6:01 a.m.
Last Modified: Tuesday, March 18, 2014 at 7:04 p.m.

Many of the Affordable Care Act enrollment events at the University of Florida have gathered just a scattering of students, and Tuesday's -- the last push before the enrollment deadline at the end of the month -- was no exception.

Scant student interest is not necessarily a bad sign, however. It likely signals the fact that at least part of the “young invincibles” who the government is keen to enroll are staying on their parents' insurance plans. The law mandates they can do so until they are 26 years old.

“Here at UF, we are blessed with a population of more well-off kids who can get health insurance through their parents,” said Jeff Feller, the CEO of WellFlorida, one of several organizations around the state charged with overseeing navigators, who help people enroll in federal health insurance.

“Still some students will fall through the cracks,” Feller added. Say if their parents are uninsured, or don't extend their coverage to their kids.

It's those students who the navigators want to reach.

For Blosmeli Leon, a UF master's of Public Health student who is helping to coordinate student enrollment, getting students information, especially on the different plan types -- Bronze, Silver, Gold, Platinum -- is crucial, since the actual online sign-up part should be easy for most students, who are largely more tech-savvy than their elders.

“A lot of youth can use the web site, so (signing up) becomes as quick as doing their Geico (auto insurance),” Feller said.

UF is also requiring all incoming students to have insurance, so “next year I would expect to see no students here” having to lean on navigators, Feller continued.

While most students tend to put health care coverage at the bottom of their heap of expenses and priorities, having it can be a lifesaver for some, said Allyson Hall, a professor at the UF College of Public Health and Health Professions.

Hall recalled past students caught off guard by emergencies -- one who got cancer, another who suffered a brain aneurysm, and another who got in a motorcycle crash. None had insurance, so all were socked with enormous bills.

While a lot of attention nationwide has been placed on attracting the “young invincibles” -- people between ages 18 and 34 -- to the marketplace because of their generally healthy status, in reality all healthy people, regardless of age, are desirable enrollees, Feller said -- for the same reason that people who don't get into auto accidents generally pay for those who do.

“Healthy people basically subsidize unhealthy people,” Feller said. That basic truth about insurance is perhaps only more emphasized under the ACA.

However, the law itself is “not a radical reform,” Hall said, adding that the ACA builds upon existing features of health coverage, including Medicaid expansion, employee-mandated health coverage, and small group health insurance plans.

Hall added that the opposition to the law also highlights the individualistic nature of how we think about financing health care. But other measures of the law emphasize quality of care -- for example, reimbursements in hospitals are now tied to quality measures that make hospitals more accountable for patient outcomes, Hall said.

Hall said the ACA is also, importantly, the “result of the political circumstances” in which it was passed. For example, the Supreme Court ruled that it was unconstitutional to oblige states to expand Medicaid.

Florida's decision not to expand Medicaid has troubled supporters of the ACA and other analysts, since it leaves approximately 764,000 Floridians in the coverage gap, according to the Kaiser Family Foundation.

That gap designates people who make too much money to get current Medicaid but too little to qualify for government subsidies as part of the health insurance exchanges.

Calls about enrollment at WellFlorida have been picking up lately, and navigators in Alachua and Marion counties have been working overtime to field people's questions as the March 31 deadline to sign up for the exchanges approaches, said Feller, who isn't directly involved in signing up people.

“They've somehow got to my phone,” he added. “I know we're ratcheting up when they've found creative ways to get me.”

As of Monday, 5 million people in the U.S. had signed up for insurance plans, still short of the 6 million mark that the Congressional Budget Office predicted would have enrolled by the end of March.

Uninsured Americans who don't sign up by the end of the month will have to pay a fine of $95, or 1 percent of their income -- whichever is higher.

There are certain exceptions to the March 31 deadline. People who get married or divorced, lose their jobs or have a baby will still be eligible to apply for the exchanges after the deadline, Feller said.

“We will be there to field calls from people with life-changing events,” Feller said.

To find out about deadline extensions, go to the health.gov website, under the “Learn” tab.

After March, WellFlorida will still be giving periodic informational talks about the health exchanges, and ramping up for the next enrollment period that begins Nov. 1.

To find a navigator in your area, go to: ncfnavigators.org. You can also call 352-299-0380; or email marketplace@wellflorida.org

Contact Kristine Crane at 338-3119, or kristine.crane@gvillesun.com

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