MIAMI — Florida's Republican leaders have fought the Affordable Care Act at every turn, banning navigators from county health departments, offering no state dollars to boost outreach efforts to 3.5 million uninsured and leading the fight to repeal the law. Yet the state has emerged as a tale of what has gone right with President Barack Obama's health care overhaul.
More than 440,000 Florida residents had been enrolled through the federal marketplace through the end of February, putting Florida on pace to exceed the federal government's initial projections by the time enrollment closes Monday.
By comparison, Republican-leaning Texas has enrolled 295,000 through the federal site, even though its population is about a third larger than Florida's.
Florida's success is due partly to infrastructure created in the swing state by Democratic-affiliated groups during the last three presidential elections, along with continued investment by the Obama administration and nonprofit advocacy groups in the diverse state that will likely be competitive in November's midterm elections.
Groups helping customers enroll in ACA-related health plans have used many of the same people who ran Obama's presidential campaigns, giving them five years of deeply entrenched relationships in communities, data to pinpoint the uninsured and veteran volunteers to track them down. The state narrowly went for Obama in 2012.
Florida's Republican leaders chose not to spend any state money marketing the new health plans to millions of uninsured, so the work was supported by $20.5 million in federal grants, plus help from the nonprofit organization Enroll America.
Florida residents also have been reached by federally funded TV, radio and digital ads. About $52 million has been spent in the past three months on the ads in Florida and the other 28 states relying on the federal marketplace, said Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services.
Florida's largest navigator grant, $4.2 million, went to the University of South Florida, which hired about 100 navigators, many of whom have years of experience enrolling people in Medicaid and a program that provides health insurance to children from low-income families.
"They have the relationships. They're already trusted as credible sources of information about health coverage," said Jodi Ray, who oversees the USF program. "That makes a big difference."