By Ronald W. Weathersby
Get Covered Nashville workers and volunteers have been combing the region to inform individuals about the benefits of the Affordable Care Act (ACA) or Obamacare. They are part of a vigorous effort across the south to inform and sign up individuals for health care under the federal law ahead of the March 31 enrollment deadline.
Sandy Bimick, a Health Assistance Specialist for Family and Children’s Services in Nashville, who has been helping the uninsured for 11 years says there are plenty of obstacles in the way of totally implementing the ACA especially in the South.
“Besides the fact that as of now the governor has not made a determination on whether to accept the Medicaid expansion there is quite a bit of misinformation about the ACA in general,” Bimick said in a telephone interview.
Bimick says she still hears about discredited rumors as the so-called “death panels” and the notion that once a person gets on Medicaid there is no incentive for them to get off.
“We have case after case of people who get on Medicaid due to an illness or injury. For example, a painter who is ill and cannot work can’t afford health care costs. Once he gets on Medicaid and can resume working he will make enough money to buy insurance.”
Across the South there is a focus to inform and insure individuals especially African-Americans which stems from the region’s large population of blacks and uninsured.
However, several Southern states opted not to run their own online health insurance exchange under the 2010 law and instead relied on the federal exchange, HealthCare.gov, which was plagued with problems in its early months. Additionally, in the face of the unquestioned need for more insurance, most Southern governors opted out of the Medicaid expansion in which the federal government promised to pay 100 percent of the costs for the first three years. The expansion would have given individuals trapped between being ineligible for Medicare and not having the financial resources to afford even the relatively low-cost of insurance through the Marketplace a viable insurance option.
Another challenge is that, compared to states running their own online health insurance marketplaces, the South received fewer resources for outreach efforts, including health care navigators to explain the law.
“We are hoping we can make a difference with limited resources,” Bimick said.
By contrast, in neighboring Kentucky the governor accepted the federal money and as of this month Erin Hoben, chief policy advisor for the Department for Medicaid Services said the expansion has made a significant difference in her state.
“Of our 640,000 uninsured before, we have enrolled 231,000 and are on track to hit 250,000 by end of month,” she said. “We’ve done a really great job of getting people enrolled and getting the word out.” she said.
Kentucky created an army of navigators it calls “Kynectors” to help people get connected and enrolled in affordable health care.
Still, in spite of the obstacles both politically and, it seems culturally, eight of the 10 states with the largest increases in health insurance enrollment from December to January were in the South, according to the Kaiser Family Foundation. Mississippi topped the list, followed by Florida and Louisiana.
“When you read the statistics about health, the health picture of black Americans is most dire,” Betty Cooper, head of Organizing for Action in northeast Louisiana, a nonprofit group that advocates for President Obama’s agenda told USA Today. “There is an extra effort … to help many more to enroll.”
Here in Tennessee the cost of the Republican leadership’s political opposition to the ACA is taking a considerable toll on health care providers and the uninsured says Bimick.
“Across our state there are 26 hospitals that are at-risk of going out of business. In rural areas the problems are acute. In Scott County residents have to wait 6 to 8 hours for emergency ambulance service. This is an economic issue also. The hospitals in many smaller counties are one of the largest employers and if they close the entire economy of some of these communities may collapse. Every hospital in Tennessee is experiencing budget cuts due to the state not expanding Medicaid.”
In Nashville, the coalition is hosting informational meetings across the area daily between now and the deadline of March 31.
Get Covered Nashville representatives will be at the Matthew Walker Health Center over the next two weeks on: Mondays, at 9 a.m.; Tuesdays, Wednesdays and Thursdays at 10 a.m.; and Fridays at 9 a.m. Additionally, the coalition will have team members at other locations across Nashville including the Downtown and Looby Libraries.
For more information about the information and enrollment meetings Bimick encourages anyone interested to call Covered Nashville at 615-724-1339.
Bimick also said that individuals who cannot afford the low-cost insurance available on HealthCare.gov should call the Health Assistance number at 615-313-9972 to learn more about available resources in the area.