Miami-Dade has Lurched Right, but Still Loves "Obamacare"Roundup
tags: Republican Party, Florida, Miami, Latino/a history, Cuban Americans
Catherine Mas is assistant professor of history at Florida International University and author of the new book, Culture in the Clinic: Miami and the Making of Modern Medicine (UNC Press).
Last week concluded the 2023 open enrollment period for the federal health insurance marketplace created by the Affordable Care Act (ACA). The program has been in place for more than 10 years, and last year, Florida was the state with the highest ACA enrollments in the country. In Miami-Dade, the state’s most populous county, the program is especially popular.
The New York Times recently reported on this “improbable” reality: that “Obamacare,” initially coined as a pejorative label, has become a key marketing tool for health insurance vendors in South Florida. Indeed, the logo is sprinkled across strip malls and storefronts, especially in Miami’s predominantly Latino neighborhoods.
It may seem surprising that Miami, of all places, should take such a liking to the program, given that the county has swung increasingly red. In the 2022 elections, residents voted overwhelmingly to elect Republicans to represent them at the local, state and national level. Republican leaders have condemned federally subsidized health insurance, appealing to Latino voters — who make up two-thirds of Miami-Dade’s population — with a message that likens liberal health policies to the “socialism” they left behind in their home countries.
But the history of health care in Miami tells a different story. In fact, recent studies have shown that Miami has long been at the forefront of changes that have sought to make American health care more affordable and accessible to diverse populations.
Take, for instance, another landmark health policy from 50 years ago: the Health Maintenance Organization Act of 1973, which created the HMO model to expand access while reducing health care spending. A health maintenance organization provided medical insurance and health services for a prepaid, fixed fee, focusing on integrated and preventive care.
At the time the policy was enacted, many people were wary of the implications that a prepayment structure would have on American medicine — which had long been based on the fee-for-service model. But Miami had shown that such a system could work.
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