The Obama Administration may have delayed a key provision of the
Affordable Care Act concerning businesses last week, but another provision that
would affect those businesses' employees -- the mandate that they must have
health insurance next year -- is still in place.
The trouble is, the majority of those people are unaware of that mandate.
To turn that disadvantage around, businesses, nonprofits and government officials are undertaking a massive outreach effort this summer, one that will accelerate as Oct. 1 -- the beginning of the open enrollment period -- approaches.
It's a big job. A national poll of the people who could most benefit by the act, also called Obamacare, shows that nearly three out of four respondents were not aware that they'll have options to buy health coverage, or even that they have to buy it.
The poll, conducted by a pro-Obamacare coalition of businesses and agencies called Enroll America, found that 72 percent of the 1,814 adults under age 65 who didn't have insurance or lost coverage were unaware of the coming changes.
"I don't think that the news is getting out too clearly and this is a grave concern for many people," said Marc I. Basist, an employee benefits consultant for Kistler Tiffany Benefits in South Whitehall Township.
The essential news is that most people who don't qualify for government-sponsored insurance such as Medicare and Medicaid or have coverage through their employer will be required to purchase health coverage in 2014. These are the people -- low- and medium-wage working individuals and families -- most affected by the Obama administration's announcement last week that it will delay to 2015 imposing penalties on medium and large businesses that don't provide insurance for their employees.
Beginning in October, those individuals and families will be able to shop for plans through an insurance exchange and, depending on their income, will have access to subsidies to defray some or all of the cost.
Prices for shoppers on Pennsylvania's exchange won't be known until September, federal officials say. In states where rates have been released, Avalere Health, a Washington-based health care consulting firm, found mixed news. Rates for a "silver" level plan for a 40-year-old nonsmoker were $205 a month in a region of Oregon, and $413 in part of Vermont. The Congressional Budget Office had estimated that the national average would be $433 per month, Avalere said.
However, rates for young, healthy people buying individual policies will still be higher than what is currently available, Avalere said. It did not publish rates for that population. The analysis also did not take into account the subsidies for which many exchange shoppers will qualify.
Many of the educational campaigns about the exchanges are already underway, and Obamacare supporters say awareness of the law will improve.
The U.S. Department of Health and Human Services, the lead agency regulating Obamacare, recently relaunched its website for educating and enlisting insurance buyers, http://www.healthcare.gov. The law also includes funding for "navigators," people who will provide personal assistance to insurance shoppers.
HHS also is trying to educate the public using "lessons learned" from its campaigns rolling out Medicare Part D and the children's health insurance program, said regional Public Affairs Officer Lorraine A. Ryan. The department will focus on getting supporters in business, faith-based groups and advocacy organizations to use their networks to inform potential insurance buyers.
"It's going to be very boots-on-the-ground," she said, saying the programs were successful in enrolling beneficiaries.
But particularly in the case of Medicare Part D, that was not the case at the start. The program, which provides funding for drug coverage for seniors, initially was marked by chaos and confusion. A National Institutes of Health review of 30 papers examining seniors' understanding of Part D showed "significant gaps in knowledge" and that most seniors initially chose plans "that did not best meet their needs" -- problems that were most pronounced when the program began in early 2006.
Federal officials are trying to follow Massachusetts' success in promoting its health insurance program a year later. There, the state brought in members of the New England Patriots to promote the program, so HHS officials proposed doing the same for Obamacare.
But Obamacare's political opponents moved to squash the proposal. NFL officials said they had no plans to get involved in a campaign after Senate Minority Leader Mitch McConnell and others last week warned them about getting involved in a program supporting a law that sparked "divisiveness" and was "persistently unpopular."
They're correct about its unpopularity. The latest Gallup poll on Obamacare shows that 52 percent of respondents disapprove of the law and 44 percent support it.
Opponents have been hammering at Obamacare since the president signed it into law in 2010. Republicans seized on the administration's decision to delay the business penalty as signs of government ineptitude and the flaws of the law.
"The president's health care law is already raising costs and costing jobs," said House Speaker John Boehner after the news broke Tuesday. "This announcement means even the Obama administration knows the 'train wreck' will only get worse. I hope the administration recognizes the need to release American families from the mandates of this law as well."
Basist, however, said it's been his experience that members of the public warm up to Obamacare when they learn about it.
"Lost in the rhetoric and the noise," he said, "are the good things," such as provisions preventing insurance companies from denying an individual coverage because of a pre-existing condition, he said.
Meantime, the HHS regional office is finalizing its public outreach campaign, which will include social media, paid ads and public service announcements, Ryan said, with celebrity endorsements still to be seen. Department heads in Washington are continuing to have promotional discussions with "a wide range of potential partners and organizations," she added.
HHS is mindful that many of those who will be recruited to sign up for insurance may not speak English well or at all, so it also is reaching out to speakers of other languages to spread the word, Ryan said, adding that healthcare.gov also is in Spanish.
The Pennsylvania Insurance Department is providing minimal assistance. "If folks are looking for information, we point them to healthcare.gov," spokeswoman Melissa Fox said. The department also is looking through materials it may provide to the public, she said.
When Gov. Tom Corbett decided against running a state-based exchange earlier this year, that left less opportunity for Pennsylvanians to learn about the law and their options. States that operate their own exchanges have access to funding to hire additional advisers called "assisters." Pennsylvania, like other states that chose a federally run exchange, does not have access to that funding.
Private organizations are deeply involved in getting the word out.
Working with the former head of the Lehigh County Conference of Churches, the Rev. Christine Nelson, Basist will hold workshops beginning next week for employers and agencies. The meetings will be held from 8-9 a.m. July 16, 18 and 25 and from 4-5 p.m. July 23 at Kistler Tiffany's offices, 1605 N. Cedar Crest Blvd., Suite 410.
In addition, the Pennsylvania Health Access Network is mobilizing its supporters and held public meetings in Philadelphia and western Pennsylvania, said Antoinette Kraus, director. She said promoters will be at county fairs throughout the summer and at libraries and other public places.
"Our organization is out in every corner of the state doing presentations to inform ... the public that open enrollment is coming in October and the importance of getting covered," Kraus said.
Enroll America last week established a Pennsylvania presence by naming Bill England statewide director. He is developing a plan to raise awareness statewide about Obamacare and intends to open a second office in western Pennsylvania.
Like the health access network, Enroll America will tap into faith-based communities, as it did at a recent meeting in Philadelphia, and human service providers, as it will at an upcoming meeting in Scranton, England said.
The organization also intends to recruit "hundreds" of volunteers to staff tables at community events, go door-to-door and work phone banks, he added. "We'll be using every campaign tool to get the word out," England said. "As we start to reach a critical mass and have enough people talking, that's when it becomes potent."
As for the fierce political opposition Obamacare has generated, England said his group is about one thing only. "We're not going after any issues that are raised beyond enrolling people" into a health insurance plan, he said.
Naturally, insurance companies have their own campaigns and plans.
On July 20, Highmark Blue Shield will open its second retail store in the Lehigh Valley, where consumers can get personal service shopping for a health plan, pay bills and more. The store will be in the Shops at Cedar Point in South Whitehall.
Highmark has a multi-faceted advertising campaign underway, including public speaking engagements, online programs and television ads now running locally, said spokesman Leilyn Perri.
Similarly, Capital BlueCross, which has a retail store in the Promenade Shops at Saucon Valley, is trying to reach new customers. "As a community health plan, we have -- since our inception 75 years ago -- always advocated that people should have health insurance," Public Relations Manager Joe Butera said.
Aetna spokesman Walt Cherniak identified the highest hurdle that advocates and insurers have to overcome: The majority of people they need to find, educate and enroll have little or no experience with health insurance.
"Aetna recognizes that for many consumers, shopping on an exchange may be their first exposure to health insurance," he said. "Our focus will be helping consumers understand their options and make informed decisions with resources, including our website, aetna.com, and customer training to assist consumers."
All of the above will be needed for consumers to work through a confusing business, said Basist, the benefits consultant.
"It's bewildering to the average person," he said. "You can get lost in the abyss. We'll get you enrolled if that's what works for you."
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