As the SEA’s resident benefit specialist, Chris Porter is used to helping people navigate complicated health care problems. So it makes sense, then, that he’s been the most involved with helping people get coverage through the Affordable Care Act (ACA). The SEA, which championed the health care overhaul, is a Certified Application Counselor organization, meaning we provide help to anyone, members or not, who reach out for help with the ACA’s HealthCare.gov web site.
This assistance proved invaluable for many after the problematic rollout of the web site. We talked with Chris about what it’s been like navigating the process and helping Granite Staters get affordable health coverage.
Question: Is it rewarding to help get people coverage?
Answer: Yes, extremely. That’s been the best part of playing a small role in the ACA enrollment process. I’ve been self-employed a few times myself, so I know from experience how expensive individual insurance can be. Seeing folks walk out the door with a $700-per-month policy, which they are able to buy for less than 10% of that amount thanks to ACA tax credits, is a really satisfying thing to witness.
Q: How much has taking people through the application process changed since the first few troubled months of HealthCare.gov?
A: The good news is that the website works quite well now, although it still throws me for a loop from time to time. As recently as yesterday, I got all the way through a couple’s application, and I could not seem to coax a letter of eligibility out of the website. I gave up and called the 800 number, only to learn that the eligibility section of healthcare.gov was “down … please check back in 24 hours.”
Fortunately, these frustrations are much fewer and farther between than in the first two months of the enrollment season. Early on, we had to resort to having people submit paper applications via snail mail. Alternatively, we asked those who were not in a rush to sit on the sidelines for a while, in the hope that the website would improve … .which it has, for the most part, on most days.
Q: How many people would you say you’ve worked with in total, whether it be over the phone or in person?
A: I’ve lost count overall, because I field so many phone calls, mostly from the general public, who found my name and number on the HealthCare.gov website. Most of these folks are just looking for advice, answers to questions and rumors, guidance on how to get started, and generally, “How does this Obamacare thing work, anyway?” Without exception, everyone has been grateful for the resource that SEA is providing, and the individual help I’ve been able to offer.
In person, I’ve worked with a few dozen individuals and couples, most of whom walked out the door happy with the enrollment process and the ACA plan they chose. When it works, it really works well, and it’s a good feeling all around.
Q: Have you helped many members (part-timers, adjuncts, etc)?
A: Yes, a fair number of adjunct professors, but relatively few state part-timers.
Q: Why should active SEA members (who have insurance) care that we’re doing this? How do they benefit?
A: If you believe that access to affordable health care is a right, rather than a privilege, then the social justice aspects of the ACA will resonate with other SEA members.
There is also an underlying hope built into the ACA that by insuring everyone, we’ll bend the cost curve on health insurance in a positive, downward direction. In turn, this may prevent the state from being subject to the so-called Cadillac tax come 2018, the indirect impacts of which will undoubtedly be felt by state employees in the form of higher cost sharing proposals being placed on the bargaining table.
Q: Have you seen anyone fall into the Medicaid gap? What did they do to end up in that situation and what can we do to fix it?
A: Yes, several times now, in person and by phone. It’s very painful … a difficult conversation to have with someone who hadn’t recognized the realities of their income and insurability.
The ACA was designed to provide for a seamless, gap-less intersection of marketplace health plans and expanded Medicaid, but the state’s reluctance to expand Medicaid has created this deep, dark Medicaid hole that folks are falling into.
They may be working, earning an income, but it’s not enough to qualify for an affordable marketplace plan, which requires that a person earn, minimally, 100 percent of the federal poverty level … a very cruel irony.