Finding uninsured people and helping them enroll in health plans through the new online marketplace -- set to open Oct. 1 -- will be hard. If they don't speak English, it will likely be harder still.
It presents an extra hurdle in states like California, Texas and Florida, as Kaiser Health News reports.
The Affordable Care Act has made funding available to community health centers to hire enrollment and outreach workers, including $21 million in May to Florida centers, but not all groups are affiliated with such centers. One is Hispanic Health Initiatives, a nonprofit based in Casselberry (near Orlando).
Josephine Mercado, executive director of Hispanic Health Initiatives, says she expects to be swamped.
"We're going to be getting the calls asking 'Where should I go, and which plan should I buy?' The challenge is doing it without getting paid. We're not going to be able to do it on an all-volunteer basis," she said. "They're already calling us."
The group is one of several in Florida -- including Covering Kids & Families at University of South Florida -- competing for federal "navigator" grants to be awarded in September. The $5.8 million in grants earmarked for Florida is not expected to be enough to deal with enrollment in a state with 3.8 million uninsured people.
At least in California, the enrollers can help all comers because that state accepted federal funds to expand Medicaid. Texas and Florida were among 26 states that did not, which means enrollers will have to tell applicants who have incomes below the federal poverty level -- $11,490 for an individual -- that they don't qualify for any help.
Undocumented immigrants are not required to buy insurance under the ACA, but they also are excluded from tax credits and subsidies for coverage through the online marketplace and will not qualify for Medicaid in the states that expanded it.
As provided in the ACA, Medicaid expansion would have brought Florida an estimated $51 billion over 10 years, while costing the state little or nothing, studies showed. The governor and Senate agreed to accept the money, but the House did not. Speaker Will Weatherford has resisted calls to rethink his stance.