I attended an all-day meeting organized by the Centers for Medicare and Medicaid Services (CMS) during which CMS representatives explained the challenges of reaching and educating the uninsured in Arizona.
The large meeting room was filled with several hundred people, most of whom work in social services across the state. There were about a dozen insurance brokers in the room and one person who said he was affiliated with a faith-based organization.
WHAT I LEARNED:
I need to use the term “Marketplace” rather than “Exchange”, as all CMS materials promote “The Marketplace” for enrolling in coverage and getting tax credits.
25% of the uninsured in Arizona did not complete high school. 17% prefer to communicate in Spanish. 48% are healthy and young. 15% are skeptical about health insurance.
The goal is to enroll one million Arizonans in health insurance. 300,000 will qualify for AHCCCS while most of the rest will enroll through the Marketplace and will get tax credits to offset their premium costs.
Organizations that will serve as Navigators have already been chosen, but Certified Application Counselors (CAC) are still applying and being reviewed. CACs will be organizations that already serve the public, such as hospitals, mental health providers, and community service groups. These groups will help people apply for tax credits and enroll in a health insurance plan.
Proper handling of personal information was emphasized over and over by each speaker. Navigators and CACs already serve the public and are not likely places for fraud or misuse of people’s private info. And most importantly, no data will be maintained by any of the counselors, either on their computers or in paper files. Navigator and CAC organizations will apply their current systems for ethics and privacy to their health insurance advising work.
A demonstration of the online application was provided and it looks very sleek and easy to use.
The Marketplace will require two steps to enroll in health insurance with tax credits (premium help).
Step 1 involves income verification to determine what kind of tax credit a person or family will get. The marketplace will be connected to a “data hub” that includes information from the IRS.
After step 1 is completed and the applicant knows how much premium help he/she will get, step 2 is to pick a health plan and enroll.
I asked the CMS representatives about claims by critics of Obamacare that income will not be verified when people apply for tax credits. The CMS representative said federally-run marketplaces will have the IRS connection, and income will be verified. He added that some state-run marketplaces might not have this connection by October 1st due to still-developing IT systems. Any misrepresentation of income would be caught when a person files taxes the next year. If a person receives tax credits that did not match his actual income, he will be required to repay the government.
“Arizona is operating on all cylinders and is in a good position for the October 1st launch”, according to Herb Schultz, Regional Director for the Department of Health and Human Services.
There is a lot of mistrust when social service providers talk about insurance brokers and agents. They seem to think all brokers/agents are going to take advantage of people. My comment: there are some bad apples out there, but most agents/brokers are ethical and doing right by their clients.
In looking over the hundreds of people who attended both meetings, I noticed that most were women. I would estimate that women outnumbered men by about ten to one. Even the attendees at the small business meeting earlier in the week were mostly women.
I suppose it is to be expected that women are more concerned than men when it comes to thinking about health care and making sure everybody is taken care of. Maybe it’s motherly instinct.
During the two-hour drive back to Tucson from Scottsdale, I was thinking about how big a project the launch of Obamacare is. The idea of reaching millions of uninsured people across the country is daunting. The thought of educating these folks and convincing them to enroll in AHCCCS/Medicaid or individual health insurance is overwhelming. And the complicated computer systems required for Obamacare seem impossible to imagine working.
This is why so many say we should not do this. It’s too hard. It’s too complicated. It won’t work. So let’s just cancel Obamacare and forget about 40 million (and more) people in the richest country in the world who are left out of our health care system. Thankfully, there are thousands of people across the country who are not afraid of the task ahead of them and are ready to get to work on Obamacare. And thank goodness for all those women!