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Knock-Knock: Obamacare Comes Calling to Your Neighborhood

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The knock on the door was unexpected. Most are when it's the feds who are calling.

Tammy Spencer
, a volunteer canvasser with the nonprofit Enroll America, didn't have an appointment. She was making her rounds, moving door-to-door on the streets of Boca Raton, looking for people in South Florida without health insurance.

Jennifer Depaz, 25, was one uninsured resident who answered the door. She told Spencer that because healthcare had gotten so expensive in the United States, she pursued a medical tourism procedure in Guatemala, where she was able to have her wisdom teeth removed at a price she could afford.

Spencer took down her information and left her with an Enroll America brochure, which provided information about how to register at the new online insurance marketplaces scheduled to open for enrollment, Oct. 1, 2013.

At this time and site, insurers will no longer be allowed to deny some 16 million currently uninsured Americans coverage or charge higher rates based on a pre-existing health condition.

Campaign-Style Technique

Volunteers like Spencer began canvassing neighborhoods in August across Florida, New Jersey, Ohio and several other states to kick off months of outreach. Enroll America is a campaign-style technique, designed by veterans of the Obama administration, to locate uninsured citizens who are unaware of the marketplaces.

Funded by Families USA, a consumer advocacy group that pushed the healthcare reform legislation, the directive has drawn criticism from Republicans in Congress.

It seems like the entire country has been talking about healthcare for reform for years, said Jonathan Edelheit, president of the Healthcare Reform Center and Policy Institute and CEO of the Medical Tourism Association. No matter how many times people have heard the sales pitch — from different lawmakers and experts — the fact of the matter is that there is a great deal of uncertainty surrounding Obamacare; especially among the uninsured who the legislation is best-intended to serve.

Their confusion might only have been magnified by the administration's surprise announcement recently postponing part of the system that affects businesses. But that change should not affect many individuals.

As healthcare reform moves closer from theory to reality, the Obama administration is looking to enroll 7 million people in the marketplaces, which, surveys show, most citizens know little about. Beginning Oct. 1, 2013, the marketplaces will offer coverage to individuals and small employers. Anyone earning less than 400 percent of the federal poverty level or $94,000 for a family of four is eligible for a government subsidy.

Enroll America says the volunteer canvassers rely on Census data and telephone survey information to target neighborhoods and homes where residents are most likely to be uninsured. Florida, and its 4 million uninsured residents, is a prime location.

The political stakes for the Obama administration in a big response are high. If only the sickest people sign up for the exchanges, the cost of their medical care could overburden insurance carriers and sink the new marketplaces. The new system depends on a balanced pool.

Tough Sell

The volunteers use a script to approach residents and try to avoid political conversations that might include Medicaid, the state-federal health program for the poor, which Florida lawmakers voted not to approve for the expansion called for under the Affordable Care Act.

Obamacare has been anything, but an easy sell. Just this week, a state commissioner predicted health insurance rates in Florida will rise by 5-20 percent in the small-group market, and 30-40 percent in the individual market, after guaranteed coverage under the Affordable Care Act takes effect next year.

The expected state hike is a measure of how tough Floridas insurance market has been for adults with pre-existing conditions, Insurance Commissioner Kevin McCarty told The Palm Beach Post.

Officials say the expected increases will be partly due to the fact consumers will receive more benefits, and the higher costs will be offset by federal subsidies in many cases. Some of the state’s largest individual health insurers, including Florida Blue and Cigna, will be among 11 plans competing through the exchange in the individual market and five insurers will offer plans in the small group market.

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