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 Democratic 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 Donald Trump hosting several rallies as part of his outreach to Latino voters.
Trump, the front-runner for the Republican presidential nomination in 2024, has pledged 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 say.
President Joe Biden's reelection campaign has already seized on Trump's statements about “Obamacare," which was enacted when Biden was vice president, as part of its broader efforts to shape the widely expected rematch with Trump next year.
“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 preexisting 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 have 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. 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 insurance through the health law. Florida leads enrollment with more than 3.2 million consumers selecting a plan during last year's enrollment period from November 2022 to January. Miami-Dade is the county with the most people enrolled, with about 750,000 consumers, or more than one-fourth of the total population.
Florida is also one of 10 states that has resisted expanding Medicaid coverage under a provision of the health law.
The two Zip codes with the most sign-ups last year and this year are in Doral and Hialeah, hubs for the Venezuelan and Cuban communities that are just north of Miami and are common stops for Trump’s visits and rallies.
Last month, Trump posted on his Truth Social social media 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. But Trump said he would not give up on terminating it — recalling when the late Sen. John McCain, R-Ariz., blocked the then-president's effort to repeal the law in July 2017.
During Trump's 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 that people in South Florida say made them feel more at ease with the plans.
The Miami Herald, in a recent editorial, called the plans by Trump — also echoed by Florida Gov. Ron DeSantis, another 2024 GOP presidential candidate — “exceedingly out of touch with voters."
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 found 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 people in the country 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 should be the responsibility of the federal government, while 1 in 5 said 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.
The Biden campaign has run advertising in battleground states contrasting his efforts to lower drug costs with Trump’s renewed promise to repeal the health overhaul. The ad campaign did not include markets in Florida.
Arevalo, one of the “Obamacare godmothers,” thinks 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.”
