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Navigating Obamacare locally–with pen and paper

When Bill Botts signed on as the Fredericksburg region’s Affordable Care Act navigator, he planned to go out into communities with a laptop and a wireless card to help people sign up for insurance through the federal health marketplace website.

But as it turned out, the laptop was little more use than a paperweight for much of the last month, as the federal health website’s technical problems largely blocked consumers—and navigators—from using it at all.

Instead, Botts has been using pen and paper a lot more than he has that laptop.

Navigators like Botts were hired to help explain the federal health reform law to consumers, and to help them apply to the federal health exchange and buy insurance there.

The ACA provides for tax subsidies to people of certain income levels to help them pay for insurance premiums, but those subsidies are available only to people who buy insurance through the official marketplace (in Virginia, the only such marketplace is the federal one, although some other states are running their own).

But to find out if they qualify for those subsidies, consumers have to apply to the marketplace, sending in tax and wage information.

The original expectation was that they could do that online, with Botts’ help if needed.

Instead, he’s been helping people send all that information through the mail.

“Suffice it to say that when the website became very problematic and people were encountering a lot of problems online, we suggested that they apply by paper,” Botts said.

Up until this week, he said, the bulk of the applications he’s helped with have been by paper.

This week, he said, people are finding more success in getting into the website, and so he’s been providing more online help.

But the online process is still glitchy in some cases.

Botts said he’s been helping one woman who needed to upload some documents to her account on the website. The website keeps showing them as uploaded, but won’t let the woman or Botts proceed to the next step.

Botts said other people are getting past that step but then are having trouble proceeding to the portion of the process where they can select a health plan.

“Of course, that’s very frustrating on the one hand, but on the other hand they have everything saved on the website, they have an account number. . . they can return at any time and hope that the glitch has been fixed,” Botts said.

He’s been telling people they can download the paper application online, as well as watch video tutorials on how to apply. Botts’ advice has been for people to fill out a paper application at home so they have the information ready to go when the website is more accessible.

He’s also been warning them that when they do apply online, to be very careful to avoid typos in filling out their information, since wrong information can result in incorrect subsidy calculations or even “engage identity proofing mechanisms.”

People can apply by paper but cannot select or buy a plan on paper—that step still has to be done on the website.

“We only know of a very few that have actually been able to get to the shopping feature,” Botts said.

That has frustrated some people who’ve come to Botts for help, he said, because they want to know what the available insurance plans might cover and what they’ll cost.

He’s been working around that by making a spreadsheet that shows examples of what a single 40-year-old in different income brackets might pay, and by showing people a Kaiser Family Foundation subsidy calculator that offers an estimate of how much of a subsidy they may qualify for.

“The question becomes OK, this all looks good . . .but what do these plans actually cover? Until this week we were telling people that you have to get to the shopping step in the healthcare.gov website process in order to do the sophisticated comparison shopping,” Botts said.

But he has discovered that if a consumer knows the name of the plan they’re interested in, they can find its details on ehealthinsur ance.com—including which doctors in the area might accept that plan.

“What we were trying to see was whether these HMOs were very inclusive, and it appeared that they were. People had been legitimately concerned that these plans were all HMOs,” Botts said. “We were pleasantly surprised to see the size of the networks, not just for primary care physicians but also for specialists.”

Overall, Botts said that in October, his office received 350 phone calls and emails requesting marketplace insurance information. He’s also done 13 community events, and said the office averages about one walk-in a day.

While he has encountered some frustrated consumers, Botts said, many of the people who seek his help are in serious need of coverage and are “very intent on getting health insurance.” That’s despite a lot of public negativity about the law’s ramifications, its consequences for those whose existing insurance has been canceled and publicity surrounding the website’s failures.

“These people are hungry and intense about getting their health insurance. They’re not in most cases ambivalent,” he said. “The negativity is there, and so they’re skeptical . . .but they come because they need the insurance, they want it and they don’t know what to expect I’ve had people be so excited, they come around from the desk and they give me a hug.”

Botts said he hopes the website is improving and said he’s already seeing an uptick in interest.

“I’ve noticed since Monday, there have been a lot more phone calls, a lot more interest, and a lot more persistence amongst our consumers that we already have ongoing cases for,” Botts said. “I have seen slow incremental improvement in the website, and I think we’re going to be refocusing our efforts on the website, as opposed to paper applications, which was our focus previously.”

He’s telling people there’s still time—they have until Dec. 15 to buy coverage that starts Jan. 1, and until next year to buy coverage and avoid tax penalties.

Chelyen Davis: 540/368-5028

cdavis@freelancestar.com

 

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