Grassroots campaign helps consumers find health-care plans before Feb. 15 Affordable Care Act deadline | News | Pittsburgh | Pittsburgh City Paper

Grassroots campaign helps consumers find health-care plans before Feb. 15 Affordable Care Act deadline

"When people are armed with the information they need, they're excited to take action"

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Under the joint grant, the group of five nonprofits committed to reaching 43,000 people and actually enrolling nearly 3,000.

Before the current open-enrollment period began, nearly 148,000 people, or 12 percent of the 1.2 million living in Allegheny County, were uninsured, according to numbers from Enroll America and Civis Analytics.

According to the latest overall numbers from the U.S. Department of Health and Human Services, nearly 71,000 residents in the Pittsburgh Metropolitan Area — which spans nine counties — have enrolled this year. About 38,000 are from Allegheny County.

The Pennsylvania Health Access Network says it's receiving more than 500 calls each week to its helpline, especially regarding HealthyPA, former Gov. Tom Corbett's controversial answer to Medicaid expansion. Its enrollment period opened in December and does not have a deadline.

Under the program, Pennsylvanians whose income is 138 percent of federal poverty limit or lower qualify — meaning a monthly income of $1,342 for a single person or $1,809 for a couple.

The program has caused a "massive amount of confusion," says Erin Ninehouser of Pennsylvania Health Access Network. "A straight-forward expansion in year one would've been the best solution."

Rather than expand Pennsylvania's existing Medicaid program, Gov. Corbett, a vocal opponent of the ACA, added another program, Healthy PA, on top of it. Though it grants coverage to 600,000 Pennsylvanians who weren't eligible under the ACA last year, it also has new conditions. For example, people who qualify must search for work, and if they miss a payment, they are locked out of coverage.

"It's helpful being around other navigators. We can help each other out with troubleshooting, especially right now with Healthy PA questions," Kayla Berkey, a navigator with the Consumer Health Coalition, said in between helping people on weekday evening at the Carnegie Library in Oakland. "We can connect with other assisters to find out what's not working so we can do advocacy to change it."

While campaigning last year, new Gov. Tom Wolf said he would adopt the federal Medicaid expansion. Last week, Kait Gillis, press secretary for Pennsylvania's Department of Human Services, said the Wolf administration is working with the "appropriate parties to review Healthy PA."

But regardless of what plan is ultimately used in Pennsylvania, the goal does not change — to get people on an affordable plan — even as these navigators face opposition. In March, the U.S. Supreme Court is set to hear a case in which the plaintiffs want to take away the tax subsidies in the 37 states that use the federal health exchanges, including Pennsylvania. This could potentially make several of the federal plans unaffordable and threaten the viability of the entire ACA.

Meanwhile, on the state level, some in the insurance industry have criticized the training of federally funded health-insurance navigators, saying they could mislead the public. The Pennsylvania Health Law Project, an organization that helps low-income, elderly and disabled consumers secure health care, says there are no examples of such harm.

PA Senate Bill No. 293 calls for tight regulations on in-person navigators and hefty fines for noncompliance. The bill would create new registration requirements by the Pennsylvania Insurance Department for enrollment assisters and "tightly control" conversations the assisters, or navigators, could have with Pennsylvanians about what insurance products to purchase, according to the Pennsylvania Health Law Project, which opposes these types of laws. A similar bill died last year.

But several people who visited navigators at Enroll America's local events said they wanted to talk to someone because they were confused about what to do.

"I wouldn't know what the heck I was doing [without navigators]," said Courtney Keeton, a student at CCAC's Allegheny Campus. "This is my first time without insurance."

Because of her rheumatoid arthritis, she says, it's important to get the medicine she needs to function every day. She said she initially completed her Healthy PA application with help from the Alma Illery Medical Center in Homewood, but she hasn't heard anything since. Murphy, the Enroll America organizer, paired her with a navigator from the YWCA.

"I didn't know this table was going to be here today," Keeton said. "I stopped by because I just wanted to see what they had to say and if I was [headed] in the right direction."

Murphy and the YWCA navigator assured her that a Healthy PA card should arrive in the mail within 30 days.

And earnestly, Murphy told her that he'd "follow up to make sure everything goes OK."

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