Nonprofit provides free help for Summit County residents trying to enroll in health insurance
Legal battles over the Affordable Care Act rage on, as they have virtually since it was passed in 2010, but the marbled courthouse halls of the East Coast are a long way from the People’s Health Clinic, where volunteers and another Utah nonprofit work to enroll people in health insurance plans.
The annual period to select a health insurance plan, called open enrollment, started Nov. 1 and lasts until Dec. 15. The window for seniors to enroll in Medicare started in mid-October.
For the last few weeks, teams of two community enrollment specialists from the Utah Health Policy Project have visited the nonprofit health clinic in Round Valley twice a week to help people navigate the potentially confusing world of health insurance.
Last year at the People’s Health Clinic, Utah Health Policy Project enrollment specialists helped about 40 people buy health insurance through the online exchange and another 10 enroll in Medicaid, according to the clinic’s executive director, Beth Armstrong. Though it’s still early, this year looks like it will have similar numbers. Armstrong described the relief and gratitude clients have felt when they walk out with health insurance.
“It relieves so much worry and pressure on top of the amount of worry and pressure they have just making ends meet,” Armstrong said. “Unfortunately it’s a luxury, health insurance is a luxury. It could be a choice of getting insurance or putting food on the table every day.”
The enrollment program’s director, Luis Rios, said there are nearly 60 different health plans offered in the state from five different providers. He and his Utah Health Policy Project team help clients sign up through the web portal and consider the merits of the dozens of plans.
Last year, the team helped 683 people statewide buy insurance through online exchanges and helped 3,300 people enroll in Medicaid, according to the nonprofit’s executive director, Matt Slonaker.
Only about a quarter of Summit County residents who are eligible for Medicaid are enrolled, according to the Center for Medicare Medicaid Services.
When people who don’t have health insurance need medical care, they often go to the emergency room. Patients are then billed directly for those costs, without the discounts normally arranged by insurance companies. That can send them into debt, Utah Health Policy Project’s education and collaborations director Courtney Bullard said. If they cannot pay, hospitals may raise prices elsewhere to compensate, she said.
The mission of People’s Health Clinic is to provide no-cost health care to the citizens of Wasatch and Summit counties who do not have health insurance.
The enrollment specialists come to the clinic on Tuesday evenings and Friday mornings and generally have two or three appointments each. Sessions can last from about 45 minutes if the situation is simple, like renewing a plan, or up to an hour and a half or so if people are negotiating the system for the first time, Rios explained.
“I challenge you to apply to ACA,” Armstrong said. “God forbid you try to do Medicaid.”
After the initial call with people seeking an appointment, the enrollment aids have an idea of the income and household-size parameters that will dictate which plans will make the most sense. Clients often have a preferred provider network — Intermountain Healthcare versus the University of Utah Health, for example — which can help narrow the number of plans down from 60 to less than 20, Rios said.
The enrollment specialists are there every step of the way, from signing up for the health care site itself to helping explain industry terms.
“Our job is to kind of help the client — the individual, the family — narrow down those options,” Rios said. “We’ll ask questions like, ‘What’s your budget?’ … (and explain things like) what a deductible is, what a copay is, coinsurance, out-of-pocket max.”
Rios estimates slightly more than half of the people Utah Health Policy Project helps speak Spanish and a similar percentage are coming in to renew their plans rather than enroll for the first time.
There are 15 specialists helping with marketplace enrollment, Rios said, but the overall program has 40-50 people statewide working to enroll people in health insurance.
Bullard said the program visits prisons, detox centers, homeless shelters and schools to access populations of people who are generally underinsured. She said Utah is notorious for having eligible children, especially Latinos, not enrolled, and that rural Utahns are an underinsured population, as well.
“Every kid — besides undocumented kids — has a coverage option,” she said. She added that her group is advocating for a program that would extend benefits to undocumented children.
She said the Utah Health Policy Project has also helped advocate for cost-saving measures like importing prescription drugs from Canada and a transparency website that would list prices and allow consumers to choose between plans.
Slonaker said the group provides training to enrollment specialists, though it doesn’t certify them. He estimated the organization answered questions or discussed health insurance with about 10,000 people last year.
“In this country, health insurance has typically been provided by employers and that your HR department answers a lot of questions you might have or handles that for you,” Slonaker said. “We’re really providing that service to low-income folks generally speaking that don’t have health insurance offerings.”
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