It was Stacey Pogue’s great idea first to get trained as Certified Application Counselors (CACs) under the oversight of a US Department of HHS-approved entity. What better way to contribute to the effort of getting Texans covered, and at the same time really find out how the new system works? Foundation Communities, a wonderful Austin non-profit whose work CPPP admires, is leading Insure Central Texas, a project for Austin and vicinity using both staff and volunteers trained as CACs to provide in-person assistance. Foundation Communities already hosts a great team of well-trained tax preparation volunteers, so they had a strong base to start with.
Having completed my online and in-person training, I was able to sign up for a 4-hour shift on the first day of open enrollment. It’s no longer news that the www.healthcare.gov web site was not functional on day one, and as I write this HHS and their contractors are still struggling with it.
On October 1, though, people were hungry for basic information, so there was plenty to talk about. With the options to consider, it seemed unlikely many folks could have been ready to complete the whole process at one sitting. In four hours, I worked with seven families. Diverse as they could be, all wanted affordable health care for their families and children.
I was happy to be able to tell two different couples (in their 50s and early 60s) with grown kids that they would qualify for discounts on their premiums. Two other families each had so much uncertainty about their 2014 income that we couldn’t be sure yet whether they would qualify for Marketplace premium help—or if the parents would fall into the Texas Medicaid Coverage Gap and stay uninsured. One mother with two children in Medicaid today learned that she was, in fact, left out in Texas due to our failure to expand Medicaid for adults. And I was able to assure an applicant that no premium discrimination would be allowed based on sexual orientation.
Each one of these families was headed by one or more workers. The highest income of the seven families I worked with that day was about $48,000, right around the median household income for Texas—half of Texan households earn less than that. All of them were courteous, appreciative, and trying hard to master their options despite the technology shortcomings. Insure Central Texas is doing a great job educating as many people as possible and trying to overcome the computer obstacles, and this work is going on in community organizations all across the country.
Uncooperative computer systems aside, it is still satisfying to see families get excited at the prospect of greater financial security and access to good care. Fingers crossed, I hope to be able to report soon on getting a family all the way to selecting a health plan and paying their first premium!