“Remember that number,” Juan Figueroa, acting chief-of-staff to Hartford’s mayor, told city staff and others trying to promote Obamacare. “Remember the number 34.”
That is, 34,000 -- the approximate number of people in Hartford who don’t have health insurance. That’s more than one in four city residents.
With about 3.4 percent of the state’s population, Hartford is home to close to 10 percent of Connecticut’s uninsured.
And so, as efforts intensify to get the state’s uninsured covered through new options becoming available under the federal health reform law, Hartford Mayor Pedro Segarra has charged the agencies he oversees with making a special push to reach "the Hartford 34,000."
“It needs to be done in a way that’s very strategic,” Segarra said. “Otherwise, even if you have the product, if you don’t market it and recruit people in an appropriate place, you could still end up with a lot of uninsured.”
Strategies and pitfalls
That’s what got a collection of city officials, community and union leaders, and staff and consultants for the state’s new insurance marketplace into a room in City Hall last week to strategize.
They discussed plans for reaching groups of people without insurance. And they identified some potential pitfalls.
Like the mural unveiling scheduled for Oct. 5.
Access Health CT, the new insurance marketplace created by Obamacare, had local artists in New Haven, Bridgeport and Hartford create murals to announce the marketplace’s opening this week. They planned to celebrate it at a community center in the city’s Frog Hollow neighborhood, with health screenings and other activities.
But Marta Bentham, director of family services and ombudsman for the city schools, said there was a problem: Hartford is a city of neighborhoods, one where the North End and South End rarely mingle.
Having a mural and face painting and other activities at a South End community center is cutesy, she said. “But you have left out an entire community.”
She suggested holding another event in the North End, so families there have the same opportunities.
“In the future, please always think, Hartford is a neighborhood place,” she said.
When Obamacare elicits 'boos'
Robert Rinker, executive director of the union CSEA/SEIU Local 2001, raised another issue: the negative views people have of Obamacare. It might not be such a big problem in Hartford, he said, where describing it as “the president’s health care plan” might encourage people to sign up for insurance.
But that’s not the case all over Connecticut. Rinker’s union represents school bus drivers, many of whom are uninsured or don’t have what he called affordable coverage. In Hartford and New Haven, bus drivers have responded well to outreach efforts, he said. But in Shelton, where most of the drivers are white, Rinker said talk of Obamacare in the bus yard drew boos.
CSEA estimates that it has 5,000 members without health insurance or affordable insurance, Rinker said. In addition to school bus drivers, it’s targeting adjunct professors at community colleges with information about new insurance options that will become available through Obamacare.
The union is also trying to reach the so-called “young invincibles,” the young, healthy people whose participation in insurance programs is considered key to keeping costs down. Community colleges already have resource people who help students apply for heating assistance and food stamps, Rinker noted, so they could also provide information on health insurance.
Those efforts are intended to supplement a more official push to enroll people in coverage -- either private insurance through Access Health, which will be available to many people at discounted rates, or through an expanded Medicaid program.
Statewide, there are about 300 people from community groups -- including churches and temples, labor unions, libraries and patient advocacy organizations -- getting trained to serve as “in-person assisters.” Those who pass a certification test will get state-issued badges and limited-function laptops to help people apply for coverage.
The application process is expected to be complicated, so much so that the head of Access Health has urged people to get help with it and to avoid filling out paper applications on their own.
The Hispanic Health Council in Hartford is one of six “navigator” organizations that will coordinate the assisters’ efforts. Grace Damio, the organization’s director of research and service initiatives, said one role will be to develop a master schedule of where assisters will be when, so it will be easy to refer people to someone who can help.
But even at peak efficiency, Damio noted, the capacity of the assisters will be limited. Hartford County has about 98,000 people without health insurance, and is expected to have, at most, 88 assisters, most of whom will be doing outreach in addition to their other jobs.
“Clearly, with the numbers that are there, we need to ... use other resources,” she said. “The numbers are daunting.”
Andrew Grossman, whose public affairs firm is helping to run the outreach effort for Access Health, told those in the room that they knew where the “connectors” and “synapses” of the community were, and the gatherings where outreach staff could go to get 50 leads on possible customers.
“And we need to tap into that,” he said.
Bentham urged those at the table to recognize that the city was, as she put it, delicate. There are many refugees in the city, and some need to be approached in a particular way. To meet with Bantu Somalis, she said, it’s important to first go through the tribal elders.
And it’s important to understand the anxieties some people will have about signing up for health coverage, Bentham said, like if a person worries that his or her own application could jeopardize a spouse who is not in the country legally.
Bentham said she could help connect those doing outreach to 21,000 Hartford families, the majority of whom don’t have insurance.
“But I need you to have in mind the sensitivity, plus the uniqueness of a large number of families,” she said.
'The Hartford 34': Good branding or more confusion?
Then there’s the question of how to brand the Hartford effort -- or whether to do it at all.
Segarra’s communications director, Maribel La Luz, and Kristina Newman-Scott, the city’s director of marketing, events and cultural affairs, developed three possible names: Hartford 34: Access Health, Capital Health, and Access: Healthy Hartford.
It would communicate to Hartford residents that, “You are part of 'The Hartford 34.' You are important to us and you are going to get insurance,” Newman-Scott said.
But Ida Colón, senior outreach advocate for the Hispanic Health Council, worried that a new title could add to the confusion that already exists. Even Access Health can be confusing for people, since it was originally referred to as an exchange, then as a marketplace. Colón said she gets a lot of calls from people who just want her to explain what it is.
“We can’t make it complicated because then they think it’s another insurance entity they can go to,” she said.
The branding would be meant to organize those doing the outreach in the city, rather than as an advertising campaign, Figueroa said, noting that it has to fit with what’s already out there.
Rinker had another suggestion: Healthy Hartford. “It’s just that simple,” he said.
Trouble is, the city health department already runs a program with that name.
Natasha Harris, who leads a dropout prevention program at Hartford Public High School for the Urban League of Greater Hartford and will work as an assister, raised a different concern: Hartford County has 98,000 people without health insurance. Isn’t the goal to insure them all?
Segarra, speaking later in the day, said he already gets questions from city residents who aren’t sure what their options will be, what it will cost, or how to sign up.
“We need to get people who are prepared to answer, in not only a clear way, but also in different languages,” he said. “We have over 75 languages that are spoken in our city.”