Lisa Sprague is a librarian. And that means she’s used to taking questions.
“Everything from answering bar bets to, ‘How do I get a job?’” she said.
So when major provisions of the federal health reform law take effect in the next few months, Sprague, who works at the Enfield Public Library, expects to get lots of inquiries. So do her colleagues in libraries across the state.
“When there are changes in systems, particularly at the state or federal level, the general public has a strong trust and feels safe going to the library and asking questions,” said Jennifer Keohane, executive director of the Connecticut Library Consortium.
But when it comes to the law commonly known as Obamacare, that can present something of a stressful situation for librarians, sticklers for accurate information and reputable sources. Polls show there’s a great deal of confusion among the public about the health law, and there’s no shortage of commentary on what it will bring.
Librarians have been concerned about what sources to refer people to, and which presentations to endorse, Keohane said.
Hoping to address that, the consortium is sponsoring a series of trainings for librarians on the health law, presented by the Universal Health Care Foundation. It’s aimed at making librarians feel more comfortable helping patrons with questions about Obamacare, and giving them the confidence to know which resources to recommend.
One librarian said a colleague in another city had already been approached by three different groups that wanted to inform the public about Obamacare, but she wasn’t sure which was a legitimate source.
Describing the changes
The Universal Health Care Foundation isn’t exactly a neutral player on health reform issues. It’s pushed for state-level reforms, including a public insurance option known as SustiNet, and was critical of the federal health law for not going far enough to change the insurance system.
Still, the material in its presentation for the librarians includes footnotes. At a recent session in Colchester, David Desiderato, a field organizer for the foundation who led the training, assured the librarians that he knew they’d take nothing less.
And it didn’t paint an entirely rosy picture of what will happen under Obamacare. In one exercise, after learning how to calculate whether people would qualify for subsidies if they buy coverage through Access Health CT, the insurance marketplace created by the health law, the librarians were asked whether people in various situations would be better off.
One scenario was fairly clear-cut: an older couple paying very high premiums now, who would become eligible for cheaper, subsidized coverage in 2014.
Another example was tougher: A single mom with two kids making $38,000, who couldn’t afford coverage for herself. Starting next year, she would qualify to buy coverage through Access Health for $192 per month. But that’s a lot of money for someone who pays nothing now and doesn’t have much extra income, noted Lynne Ide, the foundation’s director of advocacy.
“The bottom line is the Affordable Care Act’s benefits are more clear for some people than others,” she said.
“Open to all”
Why are librarians so sure they’ll get questions about Obamacare?
People come to them for tax forms, assistance with government programs, even help figuring out how to use Kindles and other devices. (Keohane said the final days of December are reliably busy as people bring in Christmas gifts they need help using.)
Libraries are a source of Internet for people who don’t have it at home, and a place for human interaction at a time when even the check-out line at the grocery store might be manned by a computer.
“Everybody trusts librarians,” said Kate Byroade, director of the Cragin Memorial Library in Colchester. “Our trust level is extremely high. A lot of groups that don’t trust government, that don’t trust schools, they trust librarians.” People who home-school their children are one example, she said.
In part, she thinks that’s because people are used to getting help in libraries, no matter what their socioeconomic status. “We help people apply for jobs,” she said. “We help people download boarding passes.”
Librarians don’t get freaked out at or bothered by questions, she noted. And they’re inclusive. Byroade cited the wording above the door of her library: “Open to all.” “Even when that means there are people who are smelly, stinky, weird, strange,” she said.
Sometimes, the questions go beyond librarians’ expertise.
When she worked as a reference librarian, Keohane said a woman asked her for help deciding whether to have reconstructive surgery after a mastectomy.
“There’s a very personal connection with the community to librarians,” she said.
“It’s a very intrinsically American thing,” she added, “The idea that with this public information, you can transform your life.”
While librarians are expecting to field questions, there’s also a more active effort under way to inform people about Obamacare and help them get coverage. And that, too, is based in large part on tapping into groups that people trust.
Access Health and the state Office of the Healthcare Advocate are training people from community groups who can tailor their pitches to target audiences.
There are close to 350,000 people without health insurance in Connecticut. According to data used by Access Health, 65 percent of the uninsured in Connecticut are minorities, and 60,000 are children. It’s estimated that 135,000 to 160,000 people could become insured because of Obamacare in 2014, either by buying coverage through Access Health or by getting Medicaid, which will have a new, higher eligibility limit.
To reach those numbers, the outreach efforts are expected to include about 300 “in-person assisters,” from community groups including churches and temples, free clinics, labor unions, towns, health advocacy organizations and hospitals. Six larger organizations, including the Hispanic Health Council in Hartford, have been designated as “navigators,” and will play a larger role in coordinating efforts and providing information about the changes and new coverage options.
Those doing the outreach work will be subject to background checks, and will have single-function laptops to help enroll people in coverage. The machines won’t have hard drives, so they can’t store any data, and will only be able to connect to the Access Health server to transmit information on people applying for coverage, said Kevin Counihan, Access Health’s CEO.
Research shows that community outreach workers are among the most trusted groups, Counihan said.
“You tend to trust your neighbor more than you’re going to trust somebody from Washington,” he said.