Help available for those struggling with enrollment

Mar. 29, 2014 @ 05:19 PM

Carmen Champion is stuck in a Catch 22.

The Henderson resident has been unemployed for five years and can’t afford the nearly $500 per month it would cost her to get coverage under the Affordable Care Act.

“As soon as the Obamacare thing came out, Rural Health connected me with some people and filled out the whole application,” Champion said. “They said I had to pay $460, and I don’t have a job.”

But the 55-year-old has fibromyalgia, a chronic condition that causes widespread pain and tenderness throughout the body. While there is no cure, it is treatable with the right medications, which she also can’t afford without insurance.

Those same prescription drugs would likely allow her to be well enough to work, which means she would be able to get insurance.

But the pain from fibromyalgia means she can’t work even though she’d like to. Because she can’t work, she can’t afford the medications that would help get her well.

“If you have insurance, you can get the right medication,” she said. “With the right medication, you can go out there and get a job. That’s how I feel. Right now, they’re just giving me what they can.”

And thus the cycle continues.

Denise Belle receives about 50 phone calls a day from people inquiring about health insurance through the marketplaces created under the Affordable Care Act.

Belle is a certified application counselor at the Rural Health Group in Henderson.

“The health literacy in this community is very low, and poverty is very high,” she said. “The fact that a lot of individuals don’t have access to the Internet and don’t feel comfortable maneuvering through various online programs, we found ourselves providing a lot of one-on-one assistance. We are having to break down the information to their level so they fully understand what they are signing up for.”

Belle said the 15 full- and part-time counselors at Rural Health Group have assisted more than 8,000 people navigate the heathcare.gov website since it went online in October.

“We see a spectrum of all ages, races and genders that are coming to receive assistance,” she said.

The Rural Health Group is a non-profit, federally funded organization that offers primary care services to individuals, regardless of whether they have health insurance.

It is also a place for people to seek help with signing up for insurance through the federal health insurance marketplace, services Champion used. A counselor told her because she’s been unemployed for as long as she has, she may be exempt from paying a penalty for not following the individual mandate.

Belle said more than 2,300 people submitted applications at the Rural Health Group, and as well as 1,391 people who they anticipate are already enrolled.

The federal government recently added a grace period for those who begin their applications before Monday’s deadline, she said.

“Those people are eligible to take some time to make a decision to finalize their enrollment,” she said. “You don’t want to pressure people and tell them that they must choose a plan if they need time to think about it.”

She said the deadline was extended to mid-April.

“The real big message is if you are uninsured and you don’t have Medicaid or Medicare, then you really need to submit an application by March 31, otherwise you will be penalized,” she said.

Belle said the most difficult questions she fields are from those who are not eligible for health insurance through the marketplace, or Medicaid and Medicare.

“There is a large population in this area that don’t have any income, that haven’t filed taxes in two years and do not intend to file taxes this year because they don’t have enough income,” she said. “It’s very disheartening to have to look those individuals in the eyes and say ‘I’m sorry but you are not eligible to purchase health insurance through the marketplace.’ When you have those situations, you try to leave people with hope.”

Contact the writer at smansur@hendersondispatch.com and vshortley@hendersondispatch.com. Follow Shortley on Twitter at @herding_stets.