By Adriana Gomez Licon | Associated Press
MIAMI — Salsa music blares from the food court in a rundown Miami shopping center as Latinos head to a kiosk and an office showing signs for “Obamacare,” where they hope to renew their health coverage plans before the year ends.
It’s areas near this mall where former President Barack Obama’s health care overhaul is more popular than anywhere in the country, according to federal data. The region has also shifted away from Democrats to Republicans in recent years, with former President Donald Trump hosting several rallies here as part of his outreach to Latino voters.
Trump has vowed to renew efforts to repeal and replace the 2010 law — something that would be felt heavily in the region and could possibly reverse some of the GOP shift among South Florida’s Latinos, experts here say.
President Joe Biden’s reelection campaign has already seized on Trump’s statements about “Obamacare,” enacted when Biden was vice president, as part of its broader efforts to shape the widely expected 2024 rematch between him and Trump.
“Health insurance is something that is extremely needed for everyone,” said Odalys Arevalo, one of the managing partners of a health insurance agency serving Spanish-speaking clients in Miami. “And I know that everybody that supports the Republican Party that has health insurance through Obamacare would not support the fact that it would be taken away from one day to another. That is a fact.”
Arevalo and her business partner, Mercy Cabrera, started enrollment centers to help people navigate the Affordable Care Act’s insurance marketplaces and remember how some Cubans would walk away uttering “no, no, no,” after seeing the name “Obamacare,” which was coined by Republicans opposing the overhaul as an expensive government takeover of health insurance.
Insurers could no longer deny coverage based on pre-existing medical conditions, and that drew many Latinos to consider it, Arevalo says. In the following years, the women started enrolling tens of thousands, earning the nickname of “Madrinas del Obamacare,” or Obamacare godmothers, evoking the crucial role godparents play in Latino culture.
They’ve since renamed themselves “Las Madrinas de los Seguros,” or insurance godmothers, because they offer other plans. But they continue to feature the word Obamacare on their office walls and in their ads.
“Obamacare” is seen throughout Miami in advertising flags, businesses and bus signs. And federal data from the Centers for Medicare & Medicaid Services indicates how widely used it is here.
About 3.4 million Hispanics are signed up with health insurance through the Affordable Care Act. Florida leads enrollment with more than 3.2 million consumers selecting a plan during last year’s enrollment period from November 2022 to January. And Miami-Dade is the county with the most people enrolled with about 750,000 consumers, or more than a fourth of the total population.
Florida is also one of 10 states that has resisted expanding Medicaid coverage under a provision of the health care law.
The two zip codes with the most signups last year and this year are in Doral and Hialeah, hubs for the Venezuelan and Cuban communities just north of Miami and common stops for Trump’s visits and rallies.
Last month, Trump posted on his Truth Social site that “the cost of Obamacare is out of control, plus, it’s not good Healthcare.” While he said he is looking at alternatives, he has not shared any plans. However, he said he would not give up on terminating it — recalling when the late Sen. John McCain, R-Ariz., blocked his long effort to repeal the law in July 2017.
During his administration, Republicans managed to pass a provision that reduced the penalty for not having health insurance to zero, the most unpopular part of the law and something locals here say made them feel more at ease with the plans.
The Miami Herald called the plans by Trump — also echoed by Florida Gov. Ron DeSantis — “exceedingly out of touch with voters” in a recent editorial.
Biden’s campaign quickly mobilized a response and the chair of the Florida Democratic Party, Nikki Fried, specifically mentioned an area where “Obamacare” is popular.
“Miami-Dade County would be hardest hit by Trump’s anti-health care agenda,” Fried said.
According to a KFF poll conducted in May 2023, 59% of Americans say they have a favorable opinion of the Affordable Care Act. The same poll by the nonprofit organization focused on health policy revealed that 66% of Hispanics say they have a favorable opinion of the law.
According to APVoteCast, a wide-ranging survey of U.S. voters, 62% of 2022 midterm voters in Florida said it should be the responsibility of the federal government to make sure that all Americans have health care coverage. About one-third of Florida voters in the 2022 midterm elections said that shouldn’t be the government’s job. Among Latino or Hispanic midterm voters in Florida, 77% said ensuring health care coverage for all Americans should be the responsibility of the federal government. One in five say it should not be.
Zulina Ruiz, a 72-year-old retired lawyer from Venezuela, said she found out about the Affordable Care Act options quickly after arriving in the U.S. in 2017. She said she is particularly grateful for having access to drugs to treat her high blood pressure. Green card holders, refugees and other migrants who have been granted temporary protected status or who have come recently with humanitarian parole also qualify for coverage under the law.
“This is very important for me. I don’t think a candidate can just make this program disappear,” she said. “They would leave millions of low-income people without insurance.”
Ruiz became a U.S. citizen in May, but has not registered with any party. She does not know whom she will vote for next year.
“I am still not decided, and we don’t have official candidates yet,” Ruiz said, adding that she still feels more connected politically to Venezuela. Much of the growing support for Republicans in Miami is owed to Trump’s record opposing socialist leaders across Latin America, including imposing White House sanctions on Venezuelan officials.
“But health policy is a top priority for me,” Ruiz said.
Biden’s reelection campaign has run advertising in battleground states contrasting Biden’s efforts to lower drug costs with Trump’s new vow to repeal the health care overhaul. It did not include markets in Florida.
Arevalo, one of the godmothers, thinks that voters in Miami may not necessarily approve of all the positions of the candidates they ultimately back.
But as far as a local verdict on Obamacare, and despite initial hesitations about it, the program grew on people in Miami once they understood it, she said.
“When Trump was elected, some people came and said they wanted nothing to do with Obamacare. We said ‘Obamacare, Trumpcare, whatever,’” she said of what they told people. “The important thing is that everybody has access to health insurance and that they can take care of their health.”