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Whidbey Island residents navigate Obamacare

Oak Harbor resident Rosa Escojido, 22, consults with Opportunity Council Lead In-Person Assister Tryphena Adams Monday about signing up for healthcare coverage to be compliant under the Affordable Care Act. - Janis Reid/Whidbey News-Times
Oak Harbor resident Rosa Escojido, 22, consults with Opportunity Council Lead In-Person Assister Tryphena Adams Monday about signing up for healthcare coverage to be compliant under the Affordable Care Act.
— image credit: Janis Reid/Whidbey News-Times

Until this past September, when he was laid off from his information technology job, Rob Rodgers and his family of four were covered by health insurance.

After he lost his job, he turned to the Washington Health Plan Finder in search of coverage available under the Affordable Care Act.

Similar to national reports, he didn’t have much success.

“We tried the website and had a horrible, horrible time,” Rodgers said.

 

 

AFTER ATTENDING a public meeting on the Affordable Care Act held by the Island County Opportunity Council last year, Rodgers and his wife were able to connect with staff and get signed up for one of the low-cost health plans through the Health Plan Finder.

When Rodgers was laid off from a second job within months, he contacted the Opportunity Council and was able to switch to an extended Medicaid program.

Rodgers said any gap in insurance would have been stressful.

“It’s a relief,” Rodgers said. “My wife is a breast cancer survivor and she has annual check-ups she needs. Plus we have two kids. You don’t want to go without.”

 

 

THE STATE’S Health Plan Finder is Washington’s response to the Affordable Care Act, commonly known as Obamacare, a federal law requiring that all Americans have health care coverage.

Obamacare includes several provisions that help low-income residents get coverage for their medical bills.

While the official closure of the open enrollment period is March 31, applicants must qualify for a program or pay their initial premium by March 23 in order to be covered by the deadline.

 

 

ONE OF the biggest changes is the provision that state Medicaid programs can be extended to wider demographic of people. In Washington state, the extended Medicaid program is called Apple Health, which is offered at no cost if the applicant or family has low or no income. It now includes dental.

To date, more than 1,800 Island County residents have enrolled in the Apple Health program and hundreds more have found insurance through the Health Plan Finder.

Rodgers said that without the new health programs, and the help from local advisors, their health care prospects would have been a “nightmare.”

“It’s been a big help,” Rodgers said.

 

 

NOT ALL applications handled by the Opportunity Council have been resolved this quickly.

Shelby Welch, a 22-year-old with a pet-sitting business, spent months trying to enroll in a health care plan starting in October.

Welch estimates she spent four to five hours at a time on the phone trying to get though on the Health Plan Finder’s 800 number. She also was unable to get through to a real person at the Opportunity Council because they were initially short staffed and untrained.

The Opportunity Council originally looked into the new insurance plans as an additional service to add to the council’s many programs, according to Lisa Clark, director of the Island County Opportunity Council.

“We attended an interest meeting, and then figured out that we were the only ones from Island County who attended,” Clark said.

For that reason, the Opportunity Council suddenly became the lead agency on the project and two staffers went through a Sept. 17 training — just a couple weeks before open enrollment began Oct. 1.

 

 

TRYPHENA ADAMS, who was hired in early October, became the Opportunity Council’s lead in-person assister and has since helped hundreds of people through the application process.

In keeping with national reports, Clark and Adams initially experienced numerous errors and system problems, causing delays and requiring applicants to reschedule appointments numerous times.

While she watched her friends get “right in” and complete their applications, Welch seemed to experience every problem imaginable.

This included system errors, computer slow downs and staffing issues.

“This is one of the most frustrating and stressful things,” Welch said.

“I’m a story of a glitch.”

AFTER BECOMING extremely frustrated with the process, Welch went to the council’s walk-in hours and camped out until she could make an appointment. That’s when she met Adams.

“The only positive thing was Tryphena,” Welch said of Adams.

Welch said despite her frustrating experience, she has seen the state and local agencies improve staffing and problem solving, making the process increasingly easy. On a recent phone call to the state’s 1-800 number, Welch said she waited under five minutes.

“It’s ten times better than October through January,” Welch said.

Based on her income, Welch qualified for Apple Health which now includes dental.

“I’m stoked about dental,” Welch said.

“That’s just a huge relief off your shoulders.”

 

 

LONGTIME SOUTH Whidbey resident Denise Hubert was uninsured the last time she had a medical emergency and ended up paying costly medical bills out of pocket.

So the Affordable Care Act was good news for Hubert.

An avid reader, Hubert had picked up bits and pieces from the news about Obamacare, but she still had a lot of questions and was unsure how to proceed.

“I was delighted to go to the public meeting,” Hubert said. “When I heard you could get in-person assistance, I thought that was even better.”

During an appointment with Adams, Hubert also experienced a series of errors on her application and it took a little work before Hubert was able to view what types of insurance she might be eligible for.

 

 

WHEN AN Island County resident logs onto the Health Plan Finder, he or she will have three insurance options if he or she doesn’t qualify for Apple Health. These plans are LifeWise, the Group Health Cooperative and Premera Blue Cross. Each available insurance offers three tiers of coverage — gold, silver and bronze — with a variety of deductible and premium levels.

Depending on the applicants income and family size, they may be eligible for tax credits that can be applied to qualified plans.

Based on the information entered into the system, the Health Plan Finder will direct applicants to the areas that apply, including Apple Health and the tax credit program.

 

 

HUBERT, WHO describes herself as a patient person, said the delays were understandable given that it was a new program that the country is figuring out as it goes. Hubert who works as a contractor for a small firm, was able to qualify for Apple Health.

“It was a little frustrating but it’s not related to any one person,” Hubert said. “And it had a good ending. I’m certainly glad to see it for this country. Health care has not been extended to everyone and it does my heart good to see that.”

 

 

THIS WEEK, Clark said that the state has worked out a lot of the errors that were initially popping up and that the Opportunity Council, which has since partnered with Whidbey General, has more staff and is better equipped to deal with difficult cases.

While the learning curve has been sharp, feedback from the community has made the process worthwhile.

The Opportunity Council has helped more than 600 residents and families through the application.

“It’s been almost overwhelming to see the response from people who have not had health insurance before,” Clark said.

“The profound relief and excitement … it has been pretty amazing.”

 

 

For information, visit www.wahealthcarefinder.org, call toll-free at 855-923-4633, or contact the Opportunity Council at 360-679-6577.

 

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