Uncertainty Greets Michigan Health Exchange

Story first appeared in The Detroit News.

Michigan's uninsured can begin buying health care online today but state officials, health advocates, insurers and hospitals are wondering whether anyone will bother.

The opening of health insurance exchanges on the Internet in Michigan and other states has been complicated by the deadlock in Washington, D.C., over Obamacare. While the marketplaces are expected to be up and running, there is concern that the shutdown could keep consumers away.

Today's opening of the online marketplace is the first in a series of key dates for Obamacare's implementation. Health care policies purchased through the exchanges won't take effect until Jan. 1, and buyers have until March 31 to sign up without penalty.

The Internet-based marketplace at www.healthcare.gov is a one-stop-shop for the uninsured to compare health insurance policies and prices, apply for federal subsidies, and enroll in a plan. All states are required to have an insurance exchange ready to go today, as required under the Affordable Care Act, also known as Obamacare.

Michigan has just over a million uninsured people, and about half of those are expected to qualify for federal tax credits to help purchase insurance on the exchange. The remainder will qualify for Medicaid after Michigan's Medicaid expansion become effective in late March or early April.

Just 1 in 8 uninsured Americans, however, is aware that the exchanges will be up and running today, according to a poll released by the Kaiser Family Foundation over the weekend. The poll also found that the public isn't any more aware of the law's key provisions than they were in 2010.

Those provisions include: dental and vision care, caps on out-of-pocket spending for prescriptions and coverage of pre-existing conditions.

"We're assuming we'll receive a high volume of calls, but we're unsure based on the polling results," said Don Hazaert, director of Michigan Consumers for Healthcare, one of four Michigan organizations that received grants from the U.S. Department of Health and Human Services to help people navigate the new health care system.

Consumers for Healthcare has a statewide network of about 300 "navigators" -- people who have been trained to provide face-to-face assistance to families and individuals who want to sign up for insurance on the exchanges. Michigan's other navigator groups are the Arab Community Center for Economic and Social Services (ACCESS); Community Bridges Management; and American Indian Health and Family Services of Southeastern Michigan.

Consumers can log on to enrollmichigan.com, or call (800) 318-2596 toll free, for phone numbers and addresses of navigators in their communities.

Hazaert said his group's network includes three Detroit organizations with navigators. The Voice of Detroit Initiative, a 14-year-old organization that coordinates health care services provided to Detroit residents, has a trained navigator as well as several Certified Assistant Counselors, people who have less training than navigators but are still able to help consumers with the application process.

"The navigator training is about a 30- to 40-hour process, and the (Certified Assistant Counselor) training is four to five hours," said Lucille Smith, executive director of Voice of Detroit, which plans to have a table set up today at St. John Connor Creek on East Outer Drive, to provide information to the public on the health exchange and how to apply for insurance.

Hospitals, health advocates and insurance agents have also been preparing for today's opening.

Oakwood Health System in Dearborn has a trained navigator on staff and about 10 employees are in the process of being trained to become Certified Assistant Counselors. They also had a town hall on the health reform, and created a video to train their 10,000 employees on the basics of Obamacare. Beaumont Health System is also training Certified Assistant Counselors, and created a website on health reform, which can be viewed at http://www.beaumont.edu/marketplace.

James Brown, owner of the Southfield-based James Brown Agency, said insurance agents are also prepared to help. He said insurance agents are better prepared than navigators to explain the intricacies of insurance to consumers because they've typically had years of experience doing that. But he doesn't expect his phone lines to be burning up today either.

"Everybody's talking about it, but I question if that many people are going to enroll the first day," Brown said Monday. "The people with medical conditions will probably the first ones in line to find out if they can afford health care."