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Deadline looms: Navigators help in Affordable Care Act enrollment

Published: Friday, March 28, 2014 5:30 a.m. CDT • Updated: Friday, March 28, 2014 2:13 p.m. CDT
Caption
(Sandy Bressner – sbressner@shawmedia.com)
Jillian Phillips of the Campaign for Better Health Care helps Patrick Ryan enroll in a healthcare program during a session Tuesday at the Unitarian Universalist Society of Geneva. The deadline to enroll in the Affordable Care Act is Monday.

GENEVA  – Jillian Phillips, a navigator for the Affordable Care Act, has been helping people sign up every Tuesday since January, hosted by the Unitarian Universalist Society of Geneva.

As the March 31 deadline to sign up approaches, procrastinators are looking to enroll for coverage. The federal government has extended the deadline for people who have started the process to enroll but have not completed it, officials said.

The Affordable Care Act, also called Obamacare, is a federal law reforming the American health care system. ObamaCare’s main focus is on improving access to affordable health insurance, improving health care and health insurance quality, regulating the health insurance industry and reducing what is spent on health care in the U.S.

Although House Republicans this month voted for the 50th time, 250-160, to roll back President Obama’s signature legislation, Phillips said some people she has helped enroll have cried with relief that they can now have health insurance coverage.

“There have been tears,” Phillips said. “I’d say 95 percent of the people are super happy to get coverage. They can finally afford coverage, especially somebody with a pre-existing condition.”

Among the pre-existing conditions that insurance companies used to deny coverage for are cancer, lupus and multiple sclerosis.

“I have to strongly reassure them to believe it,” Phillips said. “A young lady’s family who were self-identified Tea Party [members], who do not like Obama and they do not like Obamacare ... then they found out their daughter could actually get a plan that she could afford. And they were in disbelief. They thought it had to be a scam.”

Phillips, who works as a navigator for a Chicago-based nonprofit organization called Campaign for Better Health Care, said she has signed up five to 10 people each time she was on duty in Geneva but fielded many more calls than that.

She paused during her last session in Geneva between folks waiting to sign up and phone calls seeking information to talk about the Affordable Care Act.

“This area is not necessarily a high-need area, but people are still here needing help, and my phone is ringing,” Phillips said. “People call with questions ... or they’re stuck on something. I’m just pointing people in the right direction.”

Mental health and addiction services are required to be covered through the Affordable Care Act, Phillips said, something many people she helped enroll were thrilled about.

“I heard a lot: ‘You just lifted a huge weight off my shoulders,’ ” Phillips said. 

Other information Phillips imparts is to steer people to Medicaid for coverage. 

A single adult with no children who earns less than $16,000 a year, or a childless couple earning less than $20,000 a year, are now eligible for Medicaid, a federal health care program for families and individuals with low income and resources.

There is no deadline to enroll in Medicaid, she said. Those who are eligible for Medicaid are not eligible for financial help for a private plan in the health care marketplace, she said.

“I’m seeing a lot of ... people transitioning between jobs, and they have peace of mind right now that they have coverage,” Phillips said. 

People who are signed up or have insurance can still need the services of a navigator, Phillips said, if they have a “qualifying life event” such as losing their employer-based insurance because of job loss, or having a baby.

“Moving forward, a lot of people are having insurance for the first time, and they are really needing to learn how to use it,” Phillips said. “There is a role for a navigator to help them understand how it works.”

A person who did not enroll or is not eligible for Medicaid is locked out until the next enrollment session, which is Nov. 15 for the 2015 plan year, she said.

If you don’t get insurance now, you can’t wait until you become ill to try and get it, Phillips said. The mandate requires insurance coverage to be fair to providers and those who bought insurance. 

“What we have now is a system where insurance companies can no longer deny you coverage or charge you more for that coverage because of your health status,” Phillips said. “On the flip side, we also can’t let people get insurance any time of the year ... because then the market doesn’t work.”

Know more

More information about enrolling in the Affordable Health Care Act before the March 31 deadline:

• Campaign for Better Health Care - www.cbhconline.org.

• To find a navigator, call 866-311-1119 or go online at getcoveredillinois.gov.

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