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Despite Challenges To ACA, Florida Enrollment Rises


Across the country, it's the time of year when people sign up for health care plans under the Affordable Care Act. Although lawsuits and politics have raised questions about the program's future, the ACA - or Obamacare, as it's been known - is doing OK. NPR's Greg Allen reports that's especially true in Florida, which leads the nation in ACA enrollments.

GREG ALLEN, BYLINE: Donna Shalala knows a lot about health care. A former secretary of Health and Human Services in the Clinton administration, she's now a Democratic congresswoman representing a Miami district that leads the nation in enrollments under the Affordable Care Act. She says there's a reason for that.

DONNA SHALALA: We don't have a lot of big industry. There are a lot of people that are working part-time, have one or two part-time jobs that are low-income workers for whom the Affordable Care Act has been a lifesaver.

ALLEN: The Affordable Care Act has faced significant pushback since it was adopted in 2010, first from Republicans in Congress, and since 2016, from the Trump administration. The administration has slashed funds for marketing and outreach, which could be one reason enrollment dropped last year nationally. Jodi Ray, who directs a program that helps people enroll in ACA plans, says that's not the case in Florida.

JODI RAY: Florida somehow continues to remain an anomaly, and our enrollment numbers continue to go up. So basically, the Affordable Care Act is working in Florida.

ALLEN: Ray's program, Florida Covering Kids and Families, used to have 152 so-called navigators working all year to help people sign up for ACA plans. Those funds have been cut by more than 80%. But as funding has been cut for outreach, in Miami, private insurance brokers have picked up some of the slack. At a mall in Miami, Sunshine Life and Health Advisors has a kiosk with signs prominently advertising it as the place to get Obamacare. Otto Hernandez is one of the managers.

OTTO HERNANDEZ: We started with Affordable Care Act. We tried our translation in Spanish, and people had no idea what we were talking about. So most people know it by the nickname Obamacare.

ALLEN: Odalys Arevalo started the company with a partner in 2012, uncertain about how profitable it would be to enroll people in ACA plans. She's been pleasantly surprised.

ODALYS AREVALO: In the last six years, we've enrolled about 500,000 people.

ALLEN: From her kiosk at a Miami mall, her company has expanded, with locations now in Tampa, Orlando and West Palm Beach, plus hundreds of agents in Texas, Utah and other states.

MARIO SUAREZ: You know why I'm calling, right? It's that time of year again.

ALLEN: At the company's call center, Mario Suarez says many of his clients are checking in to renew their coverage. Arevalo says after several years of turmoil, the market for ACA plans has stabilized. Premiums have dropped for the second year in a row, down an average of 4% nationally. In Florida, more companies are offering ACA plans. They're all signs, she believes, that the Affordable Care Act is here to stay.

AREVALO: Now the insurance carriers are coming back into the market. I think that now carriers know that there is money to make and know how to make it. So now there's quite a different outlook on what the future of ACA is.

ALLEN: At a recent House hearing, the head of the Centers for Medicare and Medicaid credited Trump administration policies for stabilizing the market and lowering premiums. That angered some ACA advocates, but not Democratic Congresswoman Donna Shalala.

SHALALA: I'm happy they're taking credit. I want them to buy into this program.

ALLEN: In addition to cutting funds for outreach and enrollment efforts, Shalala points out that the Trump administration is supporting a federal lawsuit, now on appeal, that seeks to kill the law entirely.

SHALALA: On one hand, they're doing everything they can to destroy the program. And on the other hand, they want to take some credit for the fact that health care costs have gone down.

ALLEN: Trump administration officials are downplaying the possibility that a court ruling could suddenly leave millions of people without health care. If the ACA is struck down, they maintain, they'll have a replacement plan ready. They just won't say what it is.

Greg Allen, NPR News, Miami. Transcript provided by NPR, Copyright NPR.

As NPR's Miami correspondent, Greg Allen reports on the diverse issues and developments tied to the Southeast. He covers everything from breaking news to economic and political stories to arts and environmental stories. He moved into this role in 2006, after four years as NPR's Midwest correspondent.