2014-01-30 / Top News

Doing the right thing


The rollout of the Affordable Care Act may have been a debacle but that has not stopped an explosion of health enrollments in the program since it was first launched. According to published reports, Florida leads nationally in the total number of people taking advantage of the insurance offerings among states that did not set up their own enrollment programs. The increase in enrollment numbers track a similar trend across the country, affirming consumer interest and need. Once the HealthCare.Gov website became more functional, people slogged through the website swamp and signed up for one of multiple health insurance options available through ACA.

This short-term success is despite the controversy and misinformation that continue to plague implementation of the ACA in Florida. The state followed the cue of 20 other Republican-led state governments, declining to set up a state exchange or expand Medicaid for the benefit of the state’s neediest citizens.

It matters little that Florida has the second highest number of uninsured in the country. The Kaiser Health Institute cites efforts by state lawmakers to thwart the program from the beginning, joining a lawsuit in 2011 challenging the plan’s ca constitutionality, to restricting the guidance health care navigators provide to consumersc ov seeking coverage. The choice of state’s leadership is “missing in action” versus doing the right thing.

Given the state’s default, how will residentsr make informed decisions about the options available to them under the ACA?

Lack of access to affordable healthcare is a major issue affecting Florida’s most vulnerable citizens — the young, elderly, low income and working poor. An estimated 1.6 million Florida residents are eligible for subsidies that make healthcare more affordable.

Will they take advantage of the opportunity? The state’s policy leadership clearly hopes they can’t and won’t. Education and accurate communications on the provisions under the ACA falls to those who think it is in the public’s interest to support the plan’s success in Florida. At least for now, ACA is the law of the land.

Among the first to respond was the Health Funders Group of the Florida Philanthropic Network.

Last summer, the group came together to discuss philanthropy’s role in assisting residents to make informed decisions and receive the maximum benefits allowable under ACA. FPN subsequently published the “White Paper on the Patient Protection and Affordable Care Act and Its Implications for Florida Philanthropy.” The assessment notes the complexity of the law and the profound effect it will have on the state’s healthcare delivery systems.

It recommended that philanthropy organizations educate consumers on the options available to them, including financial support of “navigators” to assist would-be consumers; funding local needs assessments and evaluations to better understand the effects of the ACA on current healthcare delivery systems; and dissemination of findings to stakeholders to strengthen healthcare infrastructure.

The Quantum Foundation, a private foundation in Palm Beach County, was pivotal in its support of the HFG’s efforts, providing funding for the White Paper and its representative serving as the group’s co-chair. According to a foundation spokesperson, the Foundation’s priority is to ensure the people in the county take advantage of the opportunities and options for health insurance provided by the ACA. Since 2010, Quantum Foundation has invested almost $1.5 million in local navigation/enrollment efforts.

The Foundation also made grants to start-up “Navigate PBC,” a county-based program to train nonprofit staff in health navigation and for funding of direct navigation services. Participating organizations are located throughout Palm Beach County, including the Glades Initiative, Florida Community Health Center — Pahokee, Project Access, El Sol Neighborhood Resource Center, Genesis Community Health Center, and 211 Palm Beach/Treasure Coast.

A public/private sector collaboration led by Quantum placed navigators in area hospitals and in the county where high rates of the uninsured dominate, including east Boynton Beach and the Tamarind Corridor. There is far more to do.

The FPN White Paper recommends education efforts extend beyond the public to include policy makers and key stakeholders. The provisions of the law and its associated regulatory and implementation activities are a work-in-progress as the ACA continues to unfold in the state.

A bird in the hand to improve access to healthcare is a far better alternative to a head in the sand to avoid doing anything. The White Paper concludes if the state implements ACA as envisioned, a dramatic decline would follow in the number of uninsured Floridians, as well as vast improvements in financial access to healthcare, mental health and long– term care services.

That would go a long way toward ameliorating a healthcare system that is on life support for millions of Americans. ¦

— Leslie Lilly is a native Floridian and past president and CEO of the Community Foundation for Palm Beach and Martin Counties. Her professional career spans more than 25 years in the charitable sector, leading major philanthropic institutions in the South and rural Appalachia. She resides with her family and pugs in Jupiter. Email her at llilly15@gmail.com and follow Lilly on Twitter @llilly15.

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