They Have It Covered

For two Jacksonville residents who have been charged with educating citizens of Northeast Florida on the options provided under the Affordable Care Act (ACA), working to assure its success is personal because of their own experiences trying to find coverage with
pre-existing conditions.

Christina Swiridowsky, 25, is the North Central Florida regional organizing lead for 
Get Covered America. The project of the not-for-profit Enroll America is overseeing efforts, in conjunction with the U.S. Department of Health and Human Services, to educate consumers on the new health care law and options available to them on Oct. 1, when the federally run insurance marketplace opens. Her right-hand man is Tony Penna, 63, a retiree from a major health insurance company who came out of retirement to be a Community Organizer for Get Covered America.

They are two of 27 people around the state being paid to direct an army of volunteers who are holding many one-on-one conversations about the new health insurance options and what they mean for uninsured individuals and families, and then pointing them in the right direction to sign up during the Phase 1 enrollment period — Oct. 1 through March 31, 2014. The nationwide enrollment goal for the first year is 7 million of the nation’s uninsured — some 45 million in 2012, according to a survey by the Centers for Disease Control & Prevention. The ACA takes full effect
Jan. 1, 2014.

Some 350,000 of Florida’s 3.5 million uninsured reside in Duval, Nassau, Clay, 
St. Johns and Flagler counties, which are the areas of responsibility for Swiridowsky and Penna. Swiridowsky also oversees operations in Orlando and Daytona Beach media markets. Florida holds the dubious national distinction as the state with the second-highest number of uninsured residents younger than age 65, according to U.S. Census data released in late August. Statewide, Hispanics represent 36 percent of the non-elderly uninsured and African-Americans 28 percent of the
non-elderly uncovered.

Expect to see more and more Enroll America volunteers in coming months. They’ll be clearly identified by their badges as they knock on neighborhood doors, speak before civic, church and community groups, and show up at schools, special events, community centers, shopping centers and neighborhood barber shops.

“The goal is to get families talking to families, neighbors talking to neighbors and friends talking to friends about the opportunity to enroll in affordable health insurance coverage,” said Eric Conrad, spokesperson for Enroll America.

Many of the recruits also worked enthusiastically and tirelessly as volunteers, under the direction of Swiridowsky and Penna, to turn out for the vote in Northeast Florida for Barack Obama’s presidential races.

The two, who joined Enroll America June 10, also share past experience trying to secure affordable health insurance hampered by
pre-existing health conditions. ACA provisions now in effect that ban health insurers from discriminating because of pre-existing conditions have already made life better for Swiridowsky, who has been afflicted with epilepsy since childhood.

“On my ninth birthday, I suffered my first seizure. I was later diagnosed with grand mal seizures as a result of juvenile myoclonic epilepsy. To this day, I continue to battle with my epilepsy. The ACA, however, has taken away some of my worry. Not only was I allowed to stay on my mother’s insurance, my epilepsy will not be a concern as a pre-existing condition,” Swiridowsky said.

Similarly, a pre-existing condition that precluded his now 30-year-old son from receiving affordable insurance drives Penna’s passion about the need for health care reform and determination to work for its success.

“My youngest son has Crohn’s disease, which is an automatic pre-existing condition disqualifier for health insurance. When I retired, he was forced onto COBRA at a monthly cost of $800. When COBRA ran out, he was uninsurable. As a small business owner, he was able to secure a small group policy for himself and his company employees, but at an incredibly inflated monthly premium due to his condition,” Penna said.

Enroll America doesn’t sign up anyone for health care. It does not ask for a Social Security number or any banking information. Its volunteers simply inform.

They ask only for a name, address and contact information on a “commit” card with three check box options:

• Don’t currently have health insurance.

• Would like information about better coverage.

• Would like to volunteer with Enroll America.

“Unfortunately, there is a lot of misinformation, and scam artists will try to take advantage. When we reach out to you, you’ll know us by Get Covered America buttons and official Get Covered America pamphlets that will explain the basics. We will never ask you for your Social Security number, bank account number or any personal financial information. We’re here to give you just the facts about what’s to come and how you can get unbiased, independent help to enroll,” Conrad said.

The names of those requesting help to find affordable or better coverage will be passed along to “navigators,” paid employees of designated not-for-profit agencies that have received federal funding to get people enrolled in health insurance programs best suited to meet their economic and health care needs. All plans will be required to cover doctor visits, hospital stays, preventive care, prescriptions and many other basic medical needs. Tax credits are available for those whose health care costs would exceed a certain percentage of a family’s yearly income. Navigator names and the agencies they represent will be posted on the Internet closer to Oct. 1, when open enrollment officially begins.

Navigators will provide consumers with side-by-side comparisons of plans offered by providers. They will be available to advise in person, by phone or online.

They will require personal information to enroll you in a plan.

Businesses with fewer than 50 workers can get health care access through the Small Business Health Options Program, and purchasing power enjoyed by large firms. Tax credits will also be available under some circumstances.

“State records show at least 10 Florida health insurers have filed documents indicating they want to compete for shoppers on the Affordable Care Act marketplace when it opens Oct. 1,” according to health care expert Carol Gentry, founder and editor of Health News Florida (

Florida’s dismal distinction as second only to Texas in the number of uninsured corresponds with the state’s declining economy, which has been “losing ground since about 2000 on almost every measurement, including income, unemployment and inflation,” according to an Associated Press summary of the annual Labor Day report by Florida International University economists. Among the report’s findings:

• Florida median income fell at a greater pace than the rest of the nation.

• Florida poverty jumped nearly 50 percent between 2007 and 2001.

• Florida’s economic woes predate the 2008 Great Recession.

• Florida real household median income 
fell $5,668 or 11.5 percent between 2000 
and 2011.

• Between 2000 and 2012, the wage gap between high and low earners widened significantly: Paychecks of low-wage earners dropped by a half percent, while high wage earners got 13 percent more.

• Poverty increased by 47 percent between 2007 and 2001, placing 23 percent in the category of poverty or near poverty.

• Meanwhile, cost of goods on the consumer price index increased about a third between 2000 and 2012.

For one million of the state’s working poor, health care coverage is still up in the air, because the Florida House of Representatives refused to accept some $51 billion in federal funds over 10 years for Medicaid expansion, which would have covered those with incomes below the federal poverty level of $11,490 for an individual annually. Gov. Rick Scott and the State Senate supported receiving federal money.

Enroll America volunteers will have to work hard to overcome the barrage of criticism and misinformation from Affordable Care Act opponents. For Swiridowsky and Penna, and the hundreds who will be working with them, failure is not an option.

“After the first enrollment period, there is another enrollment period in the fall. We’re in this for the long run,” Conrad said. “We’re excited to join forces with organizations like USF Florida Covering Kids and Families and Health Planning Council of Northeast Florida Inc. to spread the word about open enrollment to get as many Floridians covered as possible.”