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ACA Enrollment – The Epic Story of the Two Oranges

Reports from AP and others highlight Florida’s stunning CoveredCA enrollment fete. Despite State politics around Obamacare…or perhaps because of it – February 2015 reports indicate that Florida exceeded all other states in the number of individuals enrolled in ACA.

Governing Magazine http://www.governing.com/topics/health-human-services/gov-florida-obamacare-enrollment-success-california-texas.html/ highlighted that despite California’s $400 Million budget for CoveredCA and large population, Florida, “a state where public officials have decided against using any public dollars toward enrollment – led the way.” As of February 15, 2015, Florida had added an additional 600,000 newly insured for a cumulative total of 1.6 million, according to Governance magazine. This is compared with California’s total of 1.4 million enrolled. What’s in Florida’s orange juice you might ask? Well, the general consensus is that Florida’s success is in its unique combination of strengths and weaknesses. Its strengths continue to be its well organized statewide outreach effort led by University of South Florida’s (USF) Covering Kids and Families Program. USF and its partners received the largest navigator grant in the country for Year II — $5.38 million. For Year II three counties were also added to the collaborative that had been left out of Year I’s award: Broward, Monroe and Miami which (boasted) one of the highest rates of uninsured. Prior to ACA, Miami was estimated to have as much as 30 percent of its population uninsured or more than 600.000 adults under 65. According to Kaiser Family Foundation data, in 2013 Florida’s statewide uninsured rate of 19 percent exceeded both the national rate of 13 percent and California’s rate of 15 percent. It could be argued that Florida’s rate was both a weakness and a strength.

But how did they do it? Obviously, Florida found more than one way to squeeze an orange! According to USF Navigator grant director, Jody Ray (USF’s Covering Kids & Families Program within the College of Public Health) “We’re excited to participate in Year II, and this year USF and its 12 consortium partners will be on the ground providing outreach, education and enrollment support to the entire state of Florida.  We don’t take a top-down approach, but rather one built and designed by the local communities being served.” http://hscweb3.hsc.usf.edu/blog/2014/11/18/hhs-secretary-visit-highlights-outreach-enrollment-usf-health-navigators-statewide-partners/. The federal ACA grant builds on the USF’s effective team — established with funding from the Robert Wood Johnson Foundation – that carries out year-round outreach efforts for Medicaid and CHIP enrollment.

One key resource driving Florida’s successful outreach and enrollment is its mapping tool which enabled coordinators from across the State to post, on a real-time basis, individual activities and then visualize where the services are next needed. Data points on the Data Design Network’s Heat Maps and Dashboards provided tools that allowed USF and its partners to assess level-of–effort and reallocate resources from locales which grew “hot” (high levels of outreach and application completion) to locales that were still “cool” (less penetration).

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