Originally published in The Weekly Packet, March 6, 2014
Navigators help locals enroll for health insurance
by Rich Hewitt
About four million Americans have enrolled in health care plans through the health care market place created by the Affordable Care Act, more commonly referred to as “Obamacare.” More than 20,000 of those enrollees have been Maine residents, including a growing number who live in the Blue Hill Peninsula area, Deer Isle and Stonington.
With the 2014 deadline for enrollment approaching at the end of this month, President Obama has been encouraging more people to enroll as he seeks to meet his unofficial goal of enrolling seven million Americans nationwide. The open enrollment period for 2014 ends on March 31.
There are still many area residents without health insurance and the local health care community also is urging those people to sign up. For those who are leery of tackling the enrollment forms, they suggest working with volunteers like Lynn Cheney of Blue Hill, a certified health care navigator who has recently set up shop at the Blue Hill Free Health Care Clinic. All navigator services are available free of change.
There are three ways to sign up for health insurance through the marketplace, according to Cheney: the written application filed through the mail; the telephone application, and the online application via the healthcare.gov website.
Health care navigators like Cheney are specially trained to help people work through the online process to determine if they qualify for any of the ACA policies and to review those plans and sign up for one that fits.
Cheney and Kevin Hunt of Brooksville, another local navigator working independent of the clinic, went through 20 hours of on-line training and passed a number of tests prior to the roll-out of the health care marketplace last October.
The well-publicized problems with the federal website discouraged enrollments in the Blue Hill area initially, Cheney said, but since late November more and more people have been contacting her. So far, she said, she has met with about 100 people. Of those, 80 have gone through the process and signed up for insurance.
“Things are picking up,” she said. “The process is much smoother now, and Kevin and I are much better educated about the process.”
Most of the people Cheney works with hear about her by word of mouth, even though she and Hunt traveled around the peninsula area last fall giving presentations about how they as navigators could help people through the process.
There are a number of reasons why people don’t have insurance. Some have never had it; some have had it and lost it through changes in their life or job situations. Some may have tried initially to sign up and become frustrated with the difficulties on the federal website.
There also are a variety of reasons why more people don’t come in to sign up, she said, and part of it may have to do with incomes. Under the affordable care act, the availability of insurance is based on incomes.
“In Maine, people do a lot of different things and a lot of their income is below the radar; they don’t want to put that out there” Cheney said. “And Mainers are independent; they don’t want to be forced into something.”
Also, there is a certain stigma that is attached to enrolling in the marketplace insurance plans. Opponents of Obamacare, Cheney said, often portray those who do sign up as “deadbeats” looking for a handout.
“That’s just not the case, at least with the people I’m seeing,” she said. “The people I see work hard and it would be catastrophic for them if something happened [to their health].”
One of the hardest parts of the process, she said, is to just get people to come through the door.
“It’s hard to get people to believe that this is something they can do,” she said. “Once they see what is out there, they really go for it.”
She noted that 80 percent of the people she has worked with have found an insurance plan through the marketplace. Initially, most of those people were older residents, but lately, she is seeing an increase in the younger people coming in to enroll.
That corresponds to national figures released by the U.S. Department of Health and Human Services earlier this month, which noted that enrollment of young adults grew significantly in January, increasing from 489,460 at the end of December to 807,515 as of February 1, an increase of 65 percent. Enrollment in all other age groups combined increased by 55 percent in that same period.
“It’s wonderful to see a young person get insurance for the first time, especially when they never thought they’d be able to do it,” Cheney said. “It’s a personally rewarding experience.”
It can also be a big relief for a family who has never had insurance or who has recently lost the coverage they’ve had.
The enrollment process can take between a half hour and an hour and a half depending on the size of the family. Cheney generally can screen people either over the phone or during a walk-in session during the free clinic hours and then arrange to meet individually to go through the enrollment process.
Cheney said the sessions are confidential, and part of the training she received focused on keeping an individual’s information private as they find a plan that will provide them a health insurance plan that gives them the coverage they need and that they can afford. She stressed that while the navigators are trained to explain the different plans, they never recommend one plan over another.
“We explain each of their choices, but we don’t make any recommendations,” she said. “We’re not insurance agents.”
The Affordable Care Act provides a variety of different health insurance plans which are available based on income levels. Those levels also determine whether an applicant is eligible for financial assistance. Some people make too much money to qualify for assistance, but still can sign up for insurance through the marketplace.
“They just have to pay the full rate,” she said.
Others, she said, make too little money and do not qualify. Eligibility is linked to income levels based on percentages of the federal poverty level. The Affordable Care Act assumed that individual states would expand the federal Medicaid programs which would make more, lower-income individuals eligible for that coverage, which in Maine is known as MaineCare.
Although Maine lawmakers initially approved the expansion, they were unable to muster the votes needed to override Gov. Paul LePage’s veto. As a result, a single adult in Maine who is under 65 with no children or other dependents, no longer qualified for MaineCare, Cheney said. As of January 1, about 10,000 people were kicked off MaineCare. Because of the ACA income guidelines that assumed they would be covered by state Medicaid programs, those people do not qualify for coverage under the Affordable Care Act.
“We’re seeing a number of those folks at the free clinic,” Cheney said.
Maine lawmakers are currently considering legislation that would expand coverage under MaineCare, and a vote on the measure could come as early as this week.
Anyone interested in learning more about the health care marketplace or in signing up for insurance can contact Cheney or Hunt directly to set up an appointment.
Cheney can be reached at 374-9919 or by email at email@example.com. Evans can be reached at 326-0879 or at firstname.lastname@example.org. Cheney also meets with people on a walk-in basis during the free clinic hours, 3-6 p.m. Mondays at the First Congregational Church of Blue Hill.