April 8, 2024
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Enroll America Mobilizing Locally to Promote New Health Insurance Marketplace for Individuals

Leonia, NJ—As part of The Affordable Health Care Act of 2010, adults over the age of 18 will be required to have health insurance or pay a fine. Enroll America, a non-profit, non-partisan group, has launched the Get Covered America Campaign to reach the uninsured and explain how they will benefit from buying coverage when the new Health Insurance Marketplace Exchange opens on October 1st. Using tactics borrowed from President Obama’s election campaigns, Get Covered America is using paid staff and volunteers to participate in community events, conduct door-to-door and phone bank canvassing and counsel organizations such as community centers, homeless shelters, health care facilities and businesses to tell them why they should enroll.

At a strategy meeting for volunteers, held at the Leonia Public Library on July 17, organizers reviewed the statistics of uninsured Americans and described how the new marketplace will work. Nina Anziska of Fair Lawn, Organizing Director for New Jersey, said 67 percent of the uninsured live in 13 states, including New Jersey; 78 percent do not know about the new exchange; and 83 percent don’t know that they may be eligible for Medicaid, which is being expanded.

Anziska said all participating plans will cover doctor visits, hospital stays, preventive, maternity, emergency care and prescriptions. Coverage cannot be denied due to a pre-existing condition. “The plans will contain simple language with no fine print,” she said

Enroll America will be explaining the plan but not signing people up. Registration will be available on line, through a phone hot-line or with assistance from “navigators,” trained counselors who will help people pick the best plan for them and assist in the logistics. Navigators will be hired by community groups that are currently seeking grants from the federal government to operate programs.

After opening on October 1st, coverage will go into effect in January, 2014. The exchange will close on March 14 until the following October. Anziska said the closing period will be a time to review the first implementation efforts and “tweak” aspects that need to be smoothed out. The closing period is also designed to “build up demand” by people so they realize they have to act and to “motivate” buyers to sign up before they find themselves needing coverage.

In a phone interview after the meeting, Justine Ceserano, NJ State Director of Enroll America, told JLBC that currently there are four to five health plans signed up in New Jersey. Unlike New York, which is running its own exchange, Governor Christie chose to make New Jersey part of the Federal Exchange. While all participating plans must offer a baseline of services, New Jersey plans will differ in price according to the options they offer. “The bronze level will have less expensive premiums up to the platinum level with higher premiums,” she said.

Many individuals will qualify for assistance based on income formulas, she noted. With the expansion of Medicaid, people who are at 138 percent of the poverty level in New Jersey will qualify. The unemployed whose income is above 138 percent to 400 percent of the poverty level will receive assistance from the government and those earning above 400 percent and employed but without insurance will be able able to participate in the exchange; a potential benefit to many since the requirement for small businesses with over 50 employees to offer health insurance has been delayed until 2015.

The final listing of insurers in New Jersey, and their prices, will not be available until just before the exchange opens. It has been reported that New York has about 17 plans participating and that they will be about fifty percent cheaper than they are now due to the Cuomo administration’s efforts to negotiate with them. Additionally, New York is requiring all plans to have the same premiums for everyone in the plan, partly to encourage younger, healthier people to sign up and amortize the cost of those who will need more care. Some estimates conclude that prices in New Jersey will not be much lower than they are now.

Rabbi Yossie Stern, Director of Project Ezrah, a Bergen County organization that helps people in the Jewish community to find employment and gain health insurance coverage, said he is “cautiously optimistic” about the benefits of the Health Insurance Marketplace Exchange. Project Ezrah helps about 120 families a year and gives out “millions of dollars” in assistance. Rabbi Stern said that most people Project Ezrah works with have some kind of coverage, either Medicaid; Cobra, insurance that is available for 18 months after the termination of employment; or private insurance through a spouse. He said it is difficult to persuade people whose financial lives have taken a downturn that they need help and now have to live at a lower standard than they are used to.

He is hoping that the insurance exchange will be attractive to young and healthy people who may feel that health insurance is a discretionary item that they can put off. But “illness knows no age,” he laments. He thinks the key to success will also hinge on the streamlined registration process Enroll America promises. “Most people are overwhelmed by government forms,” he said. “Ninety-percent of people want to apply but never complete the process.”

From Rabbi Stern’s vantage point, help with insurance for the unemployed and underemployed is desperately needed. He sees the effects of an economic downturn that isn’t getting better for the people Project Ezrah helps. “There isn’t always a direct correlation between government statistics on the economy and the reality. I have seen more defaults on homes in the last 5 years than I have seen in the last 40,” he said.

Rabbi Stern said that it’s hard to predict how successful the new insurance marketplace will be. “Every week, different parts of the program are chipped away. The final product won’t resemble the original.”

And the chipping continues. The Kantor Media Campaign media Analysis Group estimates that since the Affordable Care Act was passed in 2010 until it is fully implemented in 2015, over $1 billion will have been spent by groups for and against health care reform. On the legislative front, Republican legislators continue to challenge the law. They are also critical of efforts by the administration to raise funds for implementation of the law, including calls made by Kathleen Sebelius, Secretary of Health and Human Services, to persuade business executives and non-profits to assist Enroll America.

But while the politicos duke it out, the Affordable Care Act remains the law of the land and Enroll America wants the uninsured to be ready when the exchanges open on October 1st. Uninsured New Jersey residents won’t know until then if health insurance really will be more affordable than the fine they will have to pay for not being covered.

By Bracha Schwartz

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