Countdown to the Health Insurance Marketplace

Posted by AzBlueMeanie:

The Arizona Republic today has a useful article about the numerous health care groups who are hard at work trying to educate the public about the Affordable Care Act aka "ObamaCare" and to get them to enroll beginning October 1. Massive insurance sign-up planned in Arizona:

Leaders of Arizona’s social safety-net organizations may be facing the most daunting challenge of their careers.

They’re experts in their field, many with decades in the health-care
and non-profit sectors. Now, they must facilitate the biggest
health-care expansion in two generations by getting people signed up —
beginning Oct. 1 — for insurance coverage under the Affordable Care Act.

Arizona’s 1 million uninsured are a diverse group of people who,
polls show, have at least one thing in common: They know little about
the federal health-care overhaul that requires most of them to have
coverage next year or pay a fine.

Most are unaware that the new law offers free or subsidized health insurance to nearly all of them.

* * *

In Arizona, there is no state or federal agency charged with finding
them, educating them about the complexities of premiums, copays and
deductibles, or helping them enroll in the right plan. Arizonans who
don’t use insurance agents or brokers, or who don’t qualify for
Medicaid, are expected to navigate the federal online marketplace and
choose their own plan.

Gov. Jan Brewer declined to set up a state-run marketplace where
consumers could shop for insurance, limiting the public funding
available to educate the public. She cited cost, lack of state control
and the unknowns associated with running a state-based exchange when she
ceded that duty to the federal government two years ago.

[Brewer was hoping the ACA would be overturned in the Supreme Court, or repealed in Congress. She is ideologically opposed to do anything to make the program a success.]

That leaves a loose coalition of more than 300 social-service
providers, health-care organizations and advocacy groups, called Cover
Arizona, to step in. The coalition’s steering committee has been meeting
since April to hammer out strategies.

“We need to figure out how to get these people covered,” said Kim
VanPelt of the Phoenix non-profit St. Luke’s Health Initiatives, which
is coordinating Cover Arizona.

Aiding the effort is Enroll America, a national non-profit funded by the
health-care industry, insurance companies and private and non-profit
donors, and run by staffers of President Barack Obama’s re-election
campaign. Arizona is one of 10 states targeted by Enroll America because
of its large number of uninsured, lack of a state-run online insurance marketplace and its history of successful community-based health-care outreach efforts.

The health-care law set aside money for states to build and market
their own exchanges, but it didn’t anticipate that so many would opt
out. So federal funding is being transferred from public health and
other programs to the 37 federal-marketplace states for outreach and
enrollment assistance, but it’s spread thin.

Arizona non-profit groups have been awarded $5.4 million in federal
grants to hire “navigators,” outreach workers and others trained to
answer questions, encourage participation and to help people enroll
through the marketplace or in the state’s expanded Medicaid program.
Joining about 100 paid navigators and hundreds of trained application
counselors are staff and volunteers from Arizona hospitals, health
centers and advocacy organizations. Arizona’s four grantees are
scrambling to hire navigators, at annual salaries ranging from $30,000
to $40,000.

It’s a far cry from the publicity splash in some of the 17 states that have opted to build their own insurance markets.

“We have no money. We just have to work together,” Van Pelt said.

* * *

There’s a sense of urgency, particularly when it comes to reaching
people with chronic health conditions. Thousands who receive health
benefits through federal programs that end Dec. 31 are eligible for free
or subsidized coverage under the Affordable Care Act beginning Jan. 1.
But it’s not automatic; they have to enroll and they have less than
three months to do it.

People who sign up by early to mid-December should be covered when
the new insurance programs begin Jan 1. Those who purchase coverage
through the marketplace or private insurance agencies have until March
31 to enroll for 2014 coverage. Low-income Arizonans who qualify for
Medicaid can enroll anytime beginning Oct 1.

* * *

At the same time, organizers seek to dampen expectations for early
enrollment. It took years to accomplish other health-care rollouts, and
they were bumpy, such as Medicaid in the 1960s and the prescription-drug
benefit added to Medicare in 2006.

“I think it’s important to manage expectations,” VanPelt said. “I
just don’t think it’s fair to deem success or failure based on October
enrollment numbers.”

Some people will rush to sign up, motivated by ailing health or
because they already are familiar with government-run health-insurance
programs.

“We believe that those people who will be losing the pre-existing
program will be very interested in finding coverage quickly because they
know that their coverage ends January 1,” said Allen Gjersvig, director
of health-care innovation for the Arizona Alliance for Community Health
Centers.

People who have lost free health coverage since lawmakers froze
enrollment in a portion of the Arizona Health Care Cost Containment
System, the state’s Medicaid program, or who have been denied AHCCCS
coverage, also are expected to sign up early.

Organizations that traditionally help people sign up for Medicaid and
other social-service programs, such as community health centers,
hospitals, clinics, food banks and advocacy groups, have been
participating in almost daily presentations around the state. Other
partners include private companies, such as the tax-preparation company
H&R Block, which plans a pilot program with insurance agents.

Public libraries also are gearing up to assist patrons who want
insurance but lack Internet access. In a partnership with federal health
officials, the nation’s libraries are training employees about states’
online marketplaces and Medicaid policies.

The national non-profit Young Invincibles is working with the Arizona Public Interest Research Group to attract young adults, who have the highest uninsured rate of any age group but also are the least likely to know about the new health-care law. Advocates will set up tables on
college campuses to reach some of the nearly 340,000 young adults in Arizona who are uninsured.

And there’s a partnership in four states, including Arizona, among
the Centers for Medicare and Medicaid Services, community-action
agencies and the Americorps volunteer program to enlist retirees to help
low-income families find coverage.

People earning less than 133 percent of the federal poverty level, or
$15,282 for an individual, can qualify for expanded Medicaid. Those who
earn less than four times the poverty level, or up to $46,000, can
receive subsidized coverage through the online marketplace.

* * *

AHCCCS is beefing up its online enrollment system, Health-E-Arizona, to
match new eligibility requirements under the health-care overhaul. Other
than a new name — Health-E-Arizona Plus — people already on AHCCCS
won’t see much of a change, said Monica Coury, assistant AHCCCS director
for intergovernmental relations. “They’re still going to apply the way
they always applied. It’s not a massive sea change happening in
Medicaid.”

————-

To learn more about health coverage under the Affordable Care Act, go
to HealthCare.gov or call the 24/7 toll-free help line at 800-318-2596.

To find a community health center near you, go to aachc.org or call
the Arizona Alliance for Community Health Centers at 602-253-0090. In
southern Arizona, go to mypcap.org or call the Pima Community Access Program’s health hotline at 800-311-0627.

These agencies received federal “navigator” grants to help people sign up for health insurance:

Arizona Association of Community Health Centers: www.aachc.org;
602-253-0090; 700 E. Jefferson St., Suite 100, Phoenix, AZ 85034.

University of Arizona, Center for Rural Health: crh.arizona.edu; 520-626-5823.

Campesinos Sin Fronteras: www.campesinossinfronteras.org;
928-627-5995 or 928-627-1680; 201 N. Bingham Ave., Suite 1, Somerton, AZ
85350.

Greater Phoenix Urban League Inc.: www.gphxul.org; 602-254-5611; 1402 S. Seventh Ave., Phoenix, AZ 85007-3902.