As home to nearly four million residents with no health insurance and state legislators opposed to Obamacare, Florida holds a large stake in the outcome of federal healthcare reform, U.S. Health and Human Services Secretary Kathleen Sebelius told students, local health officials and politicians during a visit to Miami Dade College Tuesday.
Sebelius, who spent her third day in a week campaigning for the health law in the Sunshine State, took a few swipes at Florida Republicans for "keeping information from people" and putting them "at great risk'' when it comes to the Affordable Care Act.
But she said extensive partnerships with hospitals, community health centers, pharmacies, faith groups and nonprofits will help the federal government overcome Florida's obstacles and spread the word about healthcare reform -- especially the phase scheduled to roll out on Oct. 1: the federally-run online exchanges where millions of uninsured Americans will be able to shop for health insurance plans.
Sebelius assured the audience that the online exchanges will be ready on time. She said participating insurance companies all have signed contracts for the plans they intend to sell, and federal officials are now double-checking those plans and rates to ensure their accuracy before posting the information on the healthcare.gov website.
"For the first time ever, beginning in October,'' she said, "there will be a website available with side-by-side comparisons of plans that will be available in a particular area.''
During her visit to Miami, Sebelius focused on the impact the health law will have on Hispanics, noting that a higher proportion of Hispanic Americans are uninsured and eligible for health coverage benefits under the law than the rest of the population.
She said about 10 million Hispanic Americans across the country are uninsured and eligible, including almost 580,000 in Florida.
The law already has benefited an estimated 910,000 young Hispanic adults, she said, who have been able to remain on their parents' health insurance plans under a provision of the law mandating that insurance companies allow the benefits up to age 26.
But the bulk of Sebelius's address was directed at efforts to inform Florida's estimated 3.8 million uninsured and eligible residents about the benefits of the health law.
"The single largest challenge is to get information to individuals who may be eligible for benefits but really don't know anything about the market,'' she said. "In October, we begin really a six-month education and outreach effort."
The sign-up period for insurance purchased through the new exchanges will run from Oct. 1 through March 31.
Among the partners helping to spread the word: CVS, Walgreens and RiteAid pharmacies, which Sebelius said will offer brochures in English and Spanish statewide.
Local health groups also are pitching in.
Joining Sebelius on a stage at Miami Dade College was Karen Egozi, president of the Epilepsy Foundation of Florida, which has received a $637,000 grant from the federal government to train so-called "navigators," counselors who will help uninsured Americans in Miami-Dade shop for and enroll in health plans sold on the insurance exchanges.
Egozi said her group will train 50 counselors to work in Miami-Dade.
Andrew Behrman, president of the Florida Association of Community Health Centers, which represents more than 40 health clinics statewide, said the more than $8 million in federal grants given to state health centers in May has led to the hiring of 400 outreach and education workers, including 100 in South Florida who also will help the uninsured learn more about their options for health insurance coverage under the law.
"We're on the ground,'' Behrman said. "We will be there for you.''
Florida is ripe territory for the health law, according to data released by the U.S. Census Bureau in August, which reported that Florida has 3.8 million uninsured residents, the second-highest rate in the nation. Only Texas has a higher rate of uninsured residents. However, it is unclear if the Census count includes undocumented immigrants, who are not eligible for coverage under the health law.
Many of Florida's uninsured will be eligible for some sort of health coverage under the Affordable Care Act, Sebelius said.
But state leaders have opposed the law, rejecting one of the key measures that could provide coverage to more than one million Floridians: the expansion of Medicaid, the state-federal health program for the poor and disabled.
The U.S. Supreme Court's ruling on the health law in summer 2012 gave states the option to decide whether to expand eligibility for Medicaid to those earning up to 133 percent of the federal poverty level -- about $15,000 a year for an individual -- as called for under federal healthcare reform.
In Florida, an adult must have a dependent child and earn no more than 19 percent of the poverty level to be eligible for Medicaid.
Expansion of the program in Florida would cover an estimated 800,000 to 1.3 million residents who are now uninsured, according to a Georgetown University study. In Miami-Dade, expansion would cover an additional 150,000 to 225,000, according to the Georgetown projections.
Without Medicaid expansion, an estimated 995,000 Floridians will fall into the "coverage gap'' -- an area where people with poverty-level incomes do not qualify for Medicaid and cannot get federal subsidies to help buy health plans on the new online exchanges. Federal subsidies are only available for individuals and families living between 100 and 400 percent of the poverty level.
"They really will be without affordable options," Sebelius said, noting that many in the business community are advocating for Medicaid expansion because of the estimated $53 billion in federal funding it would bring to Florida over the next decade.
Still, Sebelius held out hope on Tuesday that Florida legislators may still accept the federal government's open-ended offer to pay for 100 percent of the cost to expand Medicaid for 2014, 2015 and 2016, and never less than 90 percent after that.
"There's still an active and ongoing and very important discussion here in Florida about Medicaid expansion,'' she said.
But Florida has been particularly inhospitable to federal healthcare reform.
Led by Gov. Rick Scott and the GOP-dominated Legislature, Republicans have questioned the security of the new Obamacare system, refused to help set up a state-based insurance exchange or expand Medicaid under the law, tried to block healthcare-outreach "navigators'' from county health departments, and stripped the state insurance commissioner's authority to negotiate or refuse rates for plans on the new online exchanges for 2014 and 2015.
Sebelius called this last act particularly reckless, emphasizing that Florida is the only state in the union to remove rate review authority from its insurance commissioner.
"The only people disadvantaged by not having rate review in Florida are the millions of consumers who now don't have the office looking out for them,'' she said.
Herald Staff Writer Marc Caputo contributed to this report. ___