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The Trouble With Enrolling In The Affordable Care Act

Across the Southwest, groups are canvassing neighborhoods to inform uninsured people about how to sign up for coverage under Obama's Affordable Care Act beginning Oct. 1. But getting the message across is a difficult task, especially reaching certain minority groups and those that may not speak English well.

Last Saturday, a handful of volunteers gathered in Phoenix to learn how to spread the word about the new health care law. Stan Williams, an organizer with the national nonprofit Enroll America, quizzed the volunteers on the essentials before they hit the streets.

"What date does open enrollment begin?" Williams asked.

"October 1," responded the volunteers.

"What date does coverage begin?" William asked.

"January 1."

Similar canvass trainings like this played out over the weekend in several states across the country.

While it is laborious to go door-to-door, Enroll America believes these conversations are best to have in person.

Some of their key talking points? Letting people know they might be eligible for financial assistance for insurance, they can't be charged more if they have preexisting conditions, and help will be available from trained 'navigators' to choose a plan.

"There are a lot of misconception out there, so we want to put a human face to these folks and say, 'Here are the facts about what happens October 1,'" Williams said.

But there's a challenge for any of these efforts.

Of Arizona's one million uninsured, about 30 percent are foreign born, and a portion of those don't speak English well.

So groups like this know they'll also need translated materials and bilingual messengers.

This is especially true in Las Vegas, where Spring Mountain Road has shopping centers packed with Korean, Japanese and Vietnamese businesses.

Edward Diansay is like many people in this community, he knows very little about the Affordable Care Act. He's from the Philippines.

"There's like a lot of things to change, but I don't really know the details," he said.

According to the 2011 census about 18 percent of Asian-Americans in Nevada are uninsured.

Emily Higby is the Business Development Director for the Asian Community Resource Center. She says her group is struggling to get the word out about the Affordable Care Act. She says there's no local broadcast media in the various Asian languages, and on top of that they often can't even communicate with each other.

"We can't even have a meeting of the Vietnamese and the Chinese and the Japanese in one room because you have to translate," Higby said.

Dan Heffley is helping Higby's group understand the law and to make their efforts more visible. He is a volunteer with the Governor's Office on Consumer Health Assistance.

"Often times you get different demographics that want to stay under the radar and they're really not aware of how it affects them," Heffley said.

Heffley said it's going to take a long time for everyone to be on the same page. He said the Obama administration may realize their time frames were too short.

Another group that's having trouble learning about the Affordable Care Act are Native Americans.

A new report from the Government Accountability Office (GAO) finds that most Native Americans would be eligible for expanded Medicaid, tax credits, or basic health care under the Affordable Care Act. The report also looked at outreach efforts by the Indian Health Service (IHS) to promote enrollment in the new program.

"We found that there was not a lot of widespread information about the expanded eligibility," said GAO spokesperson Kathleen King.

In states along the border - Texas to California - it's estimated that more than 317,000 tribal members may be eligible for expanded Medicaid services alone. At the moment, Texas is the only state in the Southwest that has opted not to expand services.

"Given the fact that so many are going to be eligible for expanded coverage, we would hope that as many as possible would take advantage of that because it is access to a broader range of services," King said.

The GAO report finished interviews in February, and the Indian Health Service says they're now ready to start implementing ACA benefits in Indian Country.

"We're doing everything we can in within our IHS operated facilities," said IHS spokesman Geoffrey Roth. "I know tribes are doing the same thing and planning to do the same thing and urban Indian programs are as well."

Unlike the rest of the population, Native Americans are exempt from the mandate to purchase coverage, and they will not pay financial penalties if they do not sign up. Still, with a majority of Native Americans living in urban areas without access to care through IHS, the ACA could fill in those insurance gaps.

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The Trouble With Enrolling In The Affordable Care Act
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Fronteras Desk
The Trouble With Enrolling In The Affordable Care Act

Jude Joffe-Block, Kate Sheehy, Tristan Ahtone