Can a puppy video get you to buy health insurance through the Affordable Care Act exchanges? Florida Blue, a major insurer in that state, hopes the answer is yes.

“It’s hard to resist puppies, right? Let’s just be honest,” says Penny Shaffer, the insurer’s South Florida regional market president, who talked to WLRN’s Sammy Mack. In the video, puppies tumble while the announcer pitches, in Spanish, affordable plans and personalized service.

According to a Commonwealth Fund analysis, Hispanics have seen the biggest increase in number of people insured of any ethnic group since the Affordable Care Act was passed. One zip code in the heart of Cuban Miami saw the most marketplace signups of any zip code in the country a couple of years ago. And market research shows that Latina women are very active video sharers.

Open enrollment for health insurance on the Affordable Care Act exchanges exchanges starts Wednesday. For anywhere from six weeks to a few months, depending on the state, people can buy plans on the individual markets for 2018.

But the Trump administration has cut the ACA advertising budget by 90 percent, as well as money to pay navigators, people who help customers pick a plan and enroll.

So across the country, municipalities, insurers and grassroots organizations are working even harder to to get the word out that the ACA is still in place. That explains the puppies.

California also sees Latinos as a key group for outreach, reports KQED’s April Dembosky. The video strategy of Covered California, that state’s marketplace, is a little different, emphasizing how important insurance is for unexpected illness.

In Phoenix, Ariz., KJZZ’s Will Stone reports that the Arizona Public Interest Research Group is part of a grassroots coalition advertising open enrollment. They are hoping to get younger people to sign up, because younger people tend to be healthier and less expensive and insurance pools need them to help pay for older and sicker people.

But Diane Brown, who heads Arizona PIRG, says consumer confusion over health insurance, complicated enough to wade through on a good day, is exacerbated by the political wrangling over the ACA.

Pennsylvania’s insurance commissioner’s office is spending some of its department’s budget on education, including setting up its own online tool to help guide consumers through how to pick a plan, reports Elana Gordon from WHYY.

And in Tennessee, Blake Farmer of Nashville Public Radio says that even though the navigator budget was cut, it was cut only by 15 percent and the state found enough savings in other places to keep roughly the same numbers.

Moving along to Texas, KUT’s Ashley Lopez finds that in the bigger cities, local taxpayers are filling in the gap. Austin is spending a lot more money this year on outreach efforts. Michelle Tijerina works for Central Health, which provides health care for low-income people in Travis County and is funded by local property taxes.

“We will have ads on radio — English and Spanish. We will be on Facebook. We will have Google ads and banners. We will be out in the community, talking to schools,” Tijenera says.

Tijerina says Central Health is also hiring twice as many people this year to help folks sign up once enrollment starts.

This story is part of a reporting partnership with NPR, local member stations and Kaiser Health News.

Let’s block ads! (Why?)

Forty days after Hurricane Maria struck Puerto Rico, most of the U.S. territory remains without power.

Over the weekend, the island’s power company fired a key contractor working to restore electrical service. The cancellation of the $300 million contract with Whitefish Energy, after the Federal Emergency Management Agency and other agencies expressed significant concerns about the deal, is expected to further delay the return of power throughout Puerto Rico.

The Puerto Rican government has prioritized getting power back to hospitals. Many smaller clinics and doctor’s offices, like other businesses on the island, still don’t have electricity.

Take, for instance, San Patricio Medflix, a diagnostic imaging center in greater San Juan. The center has state-of-the-art MRI, CT and nuclear medicine equipment.

Problems with a diesel generator recently led to the cancellation of 70 patients’ appointments, says Dr. Fernando Zalduondo Dubner, medical director of San Patricio Medflix in San Juan, Puerto Rico.

Jason Beaubien/NPR

hide caption

toggle caption

Jason Beaubien/NPR

Dr. Fernando Zalduondo Dubner, medical director imaging center, says his biggest job is battling with a heavy-duty diesel generator to keep the power on. “We are having trouble with it now as we speak,” he says.

With Puerto Rico’s electric grid down since Sept. 20, the diesel generator, housed in a metal box the size of a shipping container, has been the sole source of power for his four-story medical complex.

Fuel has been a big problem. The generator consumers about 500 gallons of diesel a day.

In the weeks after the hurricane hit, the diesel supply was incredibly tight. Zalduondo ended up buying whatever fuel he could get from whoever was selling it. But some of it was of such poor quality that it gunked up the generator. “The other day we had to cancel 70 patients that were here because we had to rely 100 percent on the diesel plant, and it just got clogged from all kinds of diesel that had been around,” he says.

For Zalduondo the stakes are higher than keeping the lights on. MRI machines like his need liquid helium to cool their superconducting magnets. If the MRI scanner loses power for very long, the helium overheats and evaporates quickly. If the helium level gets too low, the scanner can be permanently damaged.

Another radiologist in San Juan thought he had all the diesel, helium and other supplies he needed to ride out Hurricane Maria only to have his MRI machine seize up after looters drained his diesel tank. Early on Saturday morning engineers from Siemens, a medical equipment maker, were able to refill the center’s last working MRI machine’s liquid helium.

The hurricane’s winds also opened a crack in the imaging center’s roof that let water pour into much of the top floor. As the crisis has dragged on, some of Zalduondo’s employees have packed up and headed to the mainland.

“Practicing high-end radiology in Puerto Rico is extremely challenging in the best of times,” he says. “It seems like all the conditions conspire to make us radiologists leave Puerto Rico.”

The electric blackout isn’t just affecting high-end medical equipment that requires liquid helium.

Dr. Eduardo Ibarra says the conditions in Puerto Rico, including the lack of power, are killing patients who otherwise would survive.

Ibarra is making house calls to mostly elderly patients in devastated parts of Toa Baja just west of San Juan: “I would say that of the ones I visit, 100 percent don’t have electricity.

That means his patients don’t have air conditioning or even fans to keep cool, a situation which aggravates bedsores for his bedridden patients. A lot of people still don’t have running water, never mind hot water, so sanitation is poor. Their refrigerators aren’t working either, so some medicines are going bad. Some dialysis clinics have shut down, too, forcing patients to search for alternatives.

“Between no light and no water and no money and no help … the patients are getting very sick,” he says.

Even as October draws to a close, power has officially been restored to only 30 percent of customers in Puerto Rico.

On a hillside in Toa Baja, Carmen Garcia Lavoy’s relatives and neighbors are rebuilding her home with hand tools. The hurricane blew the roof and walls out of her house leaving behind a tiled cement slab littered with debris.

Dr. Ibara comes to see Garcia, who is 77. She has a host of medical issues, including high blood pressure. Last year she had open heart surgery. She also can’t see well.

Garcia she’s been very anxious living in the basement of the destroyed house with her son. Dr. Ibarra examines her in the open air of what used to be her living room. As he takes her blood pressure she breaks down crying and says she hasn’t been able to get to a doctor since the storm. “I’ve been dying to speak to my cardiologist and I’ve already cancelled or lost two appointments with him,” Garcia says.

Ibarra writes her a prescription for a blood pressure medicine that she had run out of. Garcia clutches the prescription to her chest as if it’s a treasure.

The official death toll from Hurricane Maria stands at 51, but Ibarra says far more people than that have likely died as a result of the storm. Doctors don’t write “hurricane” as the cause of death on a death certificate, he says, “the physician puts cardiac arrest, respiratory arrest.”

Let’s block ads! (Why?)