By: Nick Madigan

Having learned useful lessons during the Affordable Care Act’s first enrollment period, healthcare activists in South Florida are planning to do some things differently as they help people apply for insurance plans the second time around.

“It was very much a learning curve last year, and we were scrambling to coordinate everything,” Maura Shiffman, a community health manager for the Health Council of South Florida, said Wednesday during the kickoff of a sign-up campaign set to unfold for the act’s second enrollment period, which begins on Nov. 15 and ends on Feb. 15.

When they fan out next month, the activists — who include medical and law students and members of community health organizations — will strive to better coordinate their efforts and their message, some of the activists said during the kickoff breakfast at the Coral Gables Country Club.

They are also adding better technology to the mix, enabling people to make appointments with navigators online and through the 2-1-1 telephone switchboard. Hispanic and minority neighborhoods in which the uninsured rate is higher than average will be courted more intensely.

“Our first time around we were building a plane as we were flying it,” said Raymond Paultre, the Florida organizing director for Enroll America, whose focus is on maximizing the number of Americans who have health coverage. “We were kind of the new kids on the block a year and a half ago.”

Now, he went on, his organization has identified “a whole bunch of uninsured and under-insured people” in Florida well in advance of the enrollment period. Those people — there are about 130,000 on Enroll America’s list so far — will receive phone calls or visits in the next few weeks to urge them to enroll or to sign up for a better plan than the one they have.

There will also be a more concerted effort to ensure that the plans people enroll in are appropriate to their medical conditions, and that navigators direct them to such offerings. During the last enrollment period, many people signed up for cheaper plans that ended up not meeting their needs, especially if their medical problems called for specialists who were not part of their insurance policy, according to Santra Denis, the community health director for Catalyst Miami, formerly known as the Human Services Coalition.

Other groups represented at the meeting included the Miami Beach Community Health Center, Florida Legal Services, the Florida International University College of Law, the Jesse Trice Community Health Center, South Florida Voices for Working Families, Borinquen Health Care Center, Jackson Health System and Camillus Health.

“This was new for everybody last year,” said Lili Bach, the Florida field director for America Votes, a national organization that advances progressive policies. One of its tasks in the second year of the insurance sign-ups, Bach said, “is to make sure all the organizations work together and play nice.”

Among the impediments last year, Bach said, was a tough political climate, a situation exacerbated by the problems that bedeviled the system’s main website in its inaugural weeks.

The political noise, she went on, appears to have diminished somewhat, especially given that more than 8 million Americans are already signed up for plans under the ACA — almost 1 million of them in Florida. To make sure that those numbers grow, organizers in South Florida have planned 11 enrollment events so far, most of them at the various Miami Dade College campuses, with more in the works.

One of the issues last year was that there were too many sign-up events, some of them poorly organized. “There were all these groups that came out of the woodwork and said, ‘Hey, we want to hold an event too,’” recalled Jimmy Tan, Enroll America’s chief organizer in Miami-Dade County. “It led to a lot of chaos, and it made us spread our resources too thin. That’s not going to happen this year.”

Tan said consumers must be encouraged to not procrastinate, to do their homework and be prepared to enroll in a plan that suits them. “It’s human nature,” he said. “Most people are going to wait until the end of the enrollment period.”

Shiffman, the Health Council manager, agreed, and emphasized that the actual enrollment process is not a casual endeavor. “Plan on being there for 1 1/2 hours,” she said. “Have realistic expectations — it’s not going to take 45 minutes. And, basically, bring your life. We can only do so much without going to your house and getting the information for you.”

Marisel Losa, the Health Council’s president and CEO, said in a telephone interview that dozens of students from the University of Miami Miller School of Medicine and FIU’s College of Law have been certified as application counselors to provide personal assistance to consumers seeking health plans. In some cases, she said, applicants have to be educated on what a deductible is, or what the word “premium” means.

The students, Losa said, are being trained to ask crucial questions, such as what the precise medical needs of an applicant are, and how much of a deductible might he or she be able to afford.

“If you’ve got a physician you absolutely love,” Losa suggested, “make sure that he’s a provider on that plan.”