Agencies scurry to hire experts to explain health law

With the program known as “Obamacare” only weeks away from its key launch date, hectic preparations are in motion in communities across the country to deal with one of its major practical challenges: hiring and training a small army of instant experts who can explain the intricacies of health insurance to people who’ve never had it.

More than 100 non-profits and related organizations, which specialize in everything from running soup kitchens to organizing farmworkers, have been recruited by the federal government to sign up “navigators” to help the 30 million uninsured people who can now gain coverage.

Many of the groups have little expertise in health insurance. And the timeline for training the workers 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.

“I think there’s a lot of concern about whether, with all these state requirements, they are going to be ready to go,” said Katie Keith, a former research professor at Georgetown University, who has been tracking the health-care legislation. “You want people out there educating consumers.”

Deploying the guides for the uninsured is one of the first hurdles for the new health system as it transitions from an abstract political debate in Washington 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.

Phoenix-based St. Luke’s Health Initiatives is coordinating a coalition of local groups that plan to reach out to more than 1 million Arizonans who may be eligible for healthinsurance coverage under the Affordable Care Act.

Community groups are working together because there is so little funding in Arizona to get the word out and reach working families, young adults and other groups who could qualify for federal subsidies to purchase health insurance. One added challenge: reaching middle- class families who may not know they are eligible for subsidies. The federal law makes subsidies available for those earning up to 400 percent of the federal poverty level — $45,960 for an individual or $94,200 for a family of four.

“We know that compared to other states, the dollars dedicated to outreach and enrollment assistance are really poor,” in Arizona, said Kim VanPelt, director of St. Luke’s Health Initiatives’ Arizona Health Futures. “We are seeing this as a community effort among hundreds of organizations to provide whatever assistance they can.”

VanPelt noted that Arizona community groups have worked together to raise awareness about other parts of the healthcare law, including a highrisk insurance pool for people who could not get coverage from private insurance companies. The outreach spurred more than 4,000 Arizona residents to get coverage under the high-risk pool.

“It’s really demonstrative of the volunteer movement to get people covered,” VanPelt said.

Elsewhere around the country, the stories vary.

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 high- est percentage of uninsured residents, eight groups are receiving a total of $10.8 million and plan to train more than150 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.”