Monday, September 9, 2013
CHICAGO — With “Obamacare” only weeks away from its launch date, hectic preparations are under way to deal with a practical challenge: hiring and training a small army of instant experts who can explain health insurance to people who’ve never had it.
More than 100 nonprofits and related organizations, which do everything from soup kitchens to organizing farm workers, have been recruited by the federal government to sign up “navigators” to help the 30 million uninsured people.
Many have little expertise in health insurance. And the timeline for training is tight. According to the new health law, people can begin shopping among the new policies on Oct. 1. The enrollment period lasts six months. Coverage begins in January.
Deploying guides for the uninsured is a hurdle for the new health system as it transitions from an abstract political debate to a real-life process in communities. It is one of the steps government officials are concerned about as critics warn that the Affordable Care Act could become a “train wreck.”
The guides will be sent to community events with laptops to help people sign up for insurance online. They will work at food banks, shelters, churches and free clinics where the uninsured are likely to be.
The short time available for training raises questions about how prepared the workers will be to answer people’s questions about the different policies and government subsidies available. Community groups received the course materials for the 20-hour training only days ago. Many have just begun to post the openings on job boards.
A small scream came from Tara McCollum Plese when she was asked whether her group, Arizona Alliance for Community Health Centers, has hired any of the 45 workers authorized in its federal grant. “Ack! No,” she said Thursday. Her group has posted a job description, she said, and is now flooded with inquiries for the positions, which pay about $15 an hour. She’s since heard one worker has been hired.
Not one navigator has been hired yet under the $2 million grant obtained by the Ohio Association of Foodbanks. The Illinois Eye Institute, which will help with enrollment in the Chicago area, plans to train a dozen staffers for the task.
The work will be more difficult than what most other temporary employees, such as census workers, do. The navigators must listen to a family’s real-world story, assess its income, and figure out eligibility for the Medicaid program, which provides health care for the poor, or for new tax credits, each with its own complicated rules.
If the system works as federal officials hope, more than half of the nation’s uninsured, which amount to 15 percent of the population, will get coverage.
In Texas, with the highest percentage of uninsured residents, eight groups are receiving a total of $10.8 million and plan to train more than 150 paid workers and volunteers. Tim McKinney, CEO of United Way of Tarrant County, which got the largest grant, said many people without insurance are looking for information.
In Mississippi, workers will go into rural areas without Internet access to help people with the enrollment and policy-shopping process, which is done online.
“When Oct. 1 rolls around, we’re going to be ready to rock ‘n’ roll,” said the Rev. Michael O. Minor of Oak Hill Baptist Church in Hernando, Miss.
In 17 states, navigators have additional hoops to jump through because of new state laws affecting the federal health care law, such as required background checks for the workers.
Republican members of the House Committee on Energy and Commerce have also called on some of the assisting groups to explain how consumers will be protected when they speak with a navigator. The Republicans’ letter sets a Sept. 13 deadline for the groups to produce documents.
“This request threw us for a loop quite honestly,” said Plese of the Arizona health center group. “We haven’t even drawn down any funds from the grant.”
Will there be enough time for the hiring and training?
“It has to be enough time,” said Laura Goodhue, executive director of Florida CHAIN, a consumer health group involved in the training. “We have to do what we have to do.”