Community health centers start Obamacare enrollment

It took two days and overcoming some system glitches, but one woman Zenia Oslan worked with this week signed up for private health coverage through Access Health CT, the state’s health insurance exchange.

A man Oslan helped is still considering his options. Even though his premiums would be steeply discounted, she said, the cost seemed like it might be too much for him.

Oslan, the lead patient advocate at Hartford’s Community Health Services, has spent years helping people sign up for Medicaid and food stamps. Now she’s among scores of community health center workers helping patients enroll in new types of coverage made available as part of the health reform law commonly known as Obamacare.

Her impression of the sign-up process so far?

“Lengthy,” she said. “Very lengthy.”

Oslan described her experiences to Sen. Chris Murphy and Access Health CEO Kevin Counihan, who visited the health center Wednesday.

Murphy, a Democrat, noted that he’s proud of how Connecticut’s exchange has performed so far, contrasting it with the “inexcusable” problems that have plagued the federally run website that serves the exchanges in 36 states.

But he noted that the success of the law will depend on the work of people like Oslan, who are helping others sign up for coverage.

“It doesn’t work unless we have the volume in the exchange to be able to spread the risk,” he said.

Community health centers are considered a key piece of the health reform law, expected to treat many of the newly insured patients. Because they’re located in underserved areas and charge on a sliding scale, they treat a large share of uninsured patients — about 79,000 statewide. They have received federal funds to help enroll people in insurance and Medicaid.

Still, there have been points of friction between the health centers and the exchange, which is funding separate groups to sign people up for coverage, with health center officials concerned their outreach workers weren’t being treated equally. Unlike the exchange-funded outreach workers, health center workers helping people apply won’t get state-issued badges, and health center officials had been concerned that it could lead people to mistrust them. (The resolution to that matter: The health centers are making the badges.)

Those issues weren’t on display during the officials’ visit to Community Health Services, where close to 25 percent of the patients are uninsured.

One health center patient who went through the application process, Teresa Diaz, told Murphy about her experiences through a translator. She currently earns slightly too much money to qualify for Medicaid, but can receive coverage if she spends the excess money on medical costs. Oslan said that tends to be too much for her. When Diaz applied for Access Health coverage and saw she was eligible for it starting Jan. 1, Oslan said, she was surprised.

“It’s good,” Diaz said in English, clapping her hands together and looking up with a smile.

Murphy, who visited the Cornell Scott-Hill Health Center in New Haven earlier in the day, said he met an uninsured older man who couldn’t afford the colonoscopy his doctor said he needed. He was excited to be able to get one when his new coverage takes effect Jan. 1, Murphy said, drawing laughter at the idea of someone looking forward to that procedure.

Another man Murphy met has a son with mental health issues but can’t afford to get help, so it festers, the senator said.

Outreach workers at Hartford’s Charter Oak Health Center, who also met with Murphy and Counihan, said they had lists of patients who self-pay and plans to call them to offer help signing up for coverage. Jesse Grant, who works at Charter Oak, said he’d already called a woman who owns her own business and needs insurance.

“She was so happy that we’re now up and running,” he said.

According to the most recent data released by Access Health, as of Oct. 15, 3,847 people had signed up for coverage. About half will receive Medicaid or HUSKY B, a subsidized program for children whose parents earn too much to qualify for Medicaid. The rest signed up for private health insurance plans, although it’s not clear if any have already paid their premiums to complete the enrollment process.

Murphy said it appears that many people who learn they qualify for Medicaid sign up immediately, while those who qualify for private insurance plans are taking their time to consider their options. The state’s Medicaid program is expanding Jan. 1 as part of the health law to cover more adults who don’t have minor children.

Many uninsured people going through the application process are learning that they qualify for the state’s existing Medicaid program, said Fran Freer, a former longtime state social services official who is now consulting for the Community Health Center Association of Connecticut.

Oslan praised the Access Health call center, which she said she’s called often. In the case of the woman Oslan helped sign up for private insurance coverage this week, the Access Health website initially showed that she would qualify for discounted premiums. But when she entered her information into the system, it showed the plan costs without any discounts. Oslan said they got help from the call center and the woman was able to sign up the next day.

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