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By Tony Pugh, McClatchy Washington Bureau

WASHINGTON — After a horrendous start and months of playing catch-up against a barrage of political attacks, supporters of the Affordable Care Act have hit the homestretch in their six-month effort to educate and enroll millions of Americans in health insurance.

March 31 is the last day to buy health insurance for this year that meets the law’s mandatory coverage requirement for most Americans. Those who don’t comply with the so-called “individual mandate” face a fine when they file their 2014 income taxes next year.

Across the country, scores of volunteers will be out in force, knocking on doors, sending emails and visiting public gatherings to make sure that those who need coverage know how to get it.

Enroll America, a national support group, will organize more than 3,000 enrollment events nationwide in March. That includes one each day in every major city of their 11 target states over the last two weeks of the month.

“We will be pushing right up until the March 31 deadline to make sure as many Americans as possible are able to get covered,” said Anne Filipic, the president of Enroll America.

The Obama administration had hoped to enroll 7 million people by the end of March. But those plans quickly unraveled after technical problems with the website HealthCare.gov slowed sign-ups in the 36 states served by the federal marketplace. The nonpartisan Congressional Budget Office now expects 6 million Americans to enroll nationwide.

About 4 million people have signed up on state and federal marketplaces since open enrollment began Oct. 1. Landing 2 million more in 31 days won’t be easy, even with the crush of buyers that’s expected as the end-of-the-month deadline nears.

“We’ve always assumed, when we looked at past enrollment efforts, like Massachusetts and elsewhere, that many people would choose to wait until the deadline to make a decision about enrolling in a plan,” Filipic said. “So over the past many months we have taken the time to build the capacity that we need to meet the needs of consumers in this final critical month. That work is paying off.”

Enroll America has recruited more than 20,000 field volunteers, who, along with staff, have contacted more than 660,000 people about getting coverage. More than 180,000 confirmed that they were either under-insured or uninsured and interested in finding health plans, Filipic said.

In December, the group began reconnecting with many of these people by cards, emails and phone calls. They plan to quadruple their weekly follow-up calls in the final weeks.

“Early data shows that the likelihood that a consumer will enroll goes up with every time they’re contacted,” Filipic said. “So we are really stepping on the gas here.”

The extra effort is a must: Numerous surveys find that the uninsured are confused and uninformed about the health law, the enrollment deadline and the penalties for noncompliance with the mandate.

The latest survey by the Kaiser Family Foundation, a nonprofit health care research group, found that half of the people who reported being uninsured in February said they didn’t know how the health law would affect their families. Nearly two-thirds — 63 percent — knew a little or nothing at all about the insurance marketplaces and fewer than 1 in 4 — 24 percent — were aware of the sign-up deadline.

Since many of the uninsured have never had coverage, buying insurance is a complicated endeavor.

A new analysis from the philanthropic Robert Wood Johnson Foundation found that all U.S. adults had low levels of health insurance literacy, but the problem was worse among Hispanics and other minorities. Just 21 percent of Hispanic adults and 36 percent of non-Hispanic minorities understood key health insurance terms such as “premium” and “deductible,” compared with 52 percent of non-Hispanic whites.

“A good working knowledge of common health insurance terms is essential in order to effectively choose a health plan in the new insurance marketplaces,” said Katherine Hempstead, a senior program officer at the Robert Wood Johnson Foundation.

Enroll America will hold 15 national Latino enrollment summits in March, at which Spanish-speaking volunteers will help people sign up. Hispanic and African-American religious leaders will make a number of media appearances March 7-15 urging minorities to enroll as part of a national effort by the faith community, Filipic said.

President Barack Obama has stepped up his enrollment outreach to African-Americans through a number of interviews with nationally syndicated radio personalities.

Health and Human Services Secretary Kathleen Sebelius is working to raise awareness in states that use the federal marketplace. The department’s outreach efforts are targeting 25 cities in states with high uninsured rates, including Miami, Charlotte, N.C., St. Louis and San Antonio, which Sebelius visited Friday.

AFP Photo/Karen Bleier

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