Trenton’s Henry J. Austin Health Center Holds Kickoff Event for New Healthcare Exchanges
by TRENTON – Louis Peters has cobbled together part time jobs to support himself for the last few years, but that has also meant that the 56-year-old city resident has been without health insurance and has not been to see a primary care doctor in years. Instead, Peters said he has used the Henry J. Austin Health Center, which provides low-cost care, as his primary resource when something health-related comes up.
“It is like having a cloud over your head,” Peters said. “I can relate to having a prescription in your hand and wondering how you are going to fill it.”
Today Peters was the first in line at the heath center for assistance to sign up as New Jersey’s health insurance exchange went online this morning. The exchange is intended to allow individuals and small groups to purchase health insurance plans from an online marketplace, where they can compare plans side-by-side. Health exchanges – each state has the option of running its own or going with a federal exchange – are an essential element of the Affordable Care Act, President Barack Obama’s plan to make health insurance available to all.
But Peters and others eager to see how much they would have to pay for health coverage will have to wait. Today, Rachael Richardson, the lead clinical application counselor at the Austin center, and others logging onto the state’s online health care exchange were met with error messages and apologies.
A combination of high demand and technical glitches seemed to overwhelm the online system early in the day. Users in several states reported that they had difficulty logging on to the exchange websites. Federal and state officials were working to address the problems, which led to long waits on government websites and a federal call center.
At the Austin center, Richardson had to resign herself to filling out applications for interested patients using pen and paper, said Dr. Kemi Alli, the center’s chief medical officer.
“We are going to do it the good, old-fashioned way,” Alli said. “What we are doing for our patients, we are taking the paper applications and we are hoping that the site will be up shortly.”
I can relate to having a prescription in your hand and wondering how you are going to fill it. Alli said that Richardson, who has been hired to oversee the counseling process for patients to ensure that they are aware of all of their options, will follow up with patients when the site is back online to guide them through the process.
The guides at the Austin center said they received training beforehand on how to use the exchange through online tutorials that explained terminology, usage and offerings. But little could be accomplished todaywith the exchange system not working properly.
To be covered on Jan. 1, people need to sign up and pay for their first month of coverage by Dec. 15. If they fail to have health insurance in 2014, they will have to pay a tax penalty of $95 or 1 percent of their income, whichever is greater. People have until the end of March to sign up in order to avoid tax penalties.
The Austin center was granted $135,000 this year to hire one full time and one part time position to assist Richardson in guiding patients.
Richardson said the center also plans to reach out to the community with events, so they can help other residents enroll in the exchange, even if they are not patients at the health center.
The Trenton Health Team, a collaboration of city hospital and government officials with the goal of addressing health-care issues, said it hopes to attract volunteers who can work to enroll patients alongside members of their existing care team.
Structures are already in place at Capital Health and St. Francis Medical Center to enroll patients in Medicaid. That same system will be expanded to give guidance to uninsured patients interested in purchasing health care from the exchange, said Christy Stephenson, interim CEO at St. Francis Medical Center.
“We are absolutely committed to helping people enroll,” Stephenson said. “I think that there is an initial hurdle when thinking about how difficult this is and how complex it is to get enrolled. The individuals at St. Francis who have taken the training say that it is really not that difficult.”
The New Jersey exchanges will offer insurance plans from AmeriHealth New Jersey, Horizon Blue Cross Blue Shield of New Jersey and Health Republic Insurance, a New York-based co-op insurance provider.
The marketplaces represent a turning point in the nation’s approach to health care, the biggest expansion in coverage in nearly 50 years.
The Obama administration hopes to sign up 7 million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.
But if people become frustrated with the malfunctions in the computer-based enrollment process and turn away from the program, the prospects for Obama’s signature domestic policy achievement could dim.
“You’ve got to launch this thing right the first time,” said Robert Laszewski, a consultant who worked 20 years in the insurance industry. “If you don’t, financially, you will never recover.”
AmeriHealth, Horizon and Health Republic have their own exchange-like websites where customers can come to purchase their individual or small group insurance, but users cannot see side-by-side comparisons of what each of the three companies offer. The three websites were up and running today, even though the government’s websites were down.
“What we have had control over has gone pretty well,” said Mike Munoz, senior vice president of sales and marketing at AmeriHealth.
Thomas Vincz, a spokesman for Horizon, said the company is reminding customers that the enrollment period does run until the end of March, so there is still time to enroll via the exchanges.
Bill Rue Jr., president of Rue Insurance in Hamilton, said he has been trying to advise his clients about the offerings on the exchange, but because they could not get online, they had to put it off for another day.
“Mostly our position is, let’s give it a bit of time because the plans don’t start until January 1 anyway,” Rue said.
Rue said he is eager to see how the cost of the plans offered on the exchange compare to his client’s existing health plans.
Munoz said AmeriHealth has been working to ensure that there are a range of options for individuals and businesses on the exchange.
“We have given a lot of variation in our offering,” he said. “For the most part we feel that we have seen in the marketplace that we are extremely competitive.”
He said the company is expecting that the health care exchanges will attract people who are “strivers”- which he describes as people of all ethnicities who are on the lower income range, but do not qualify for Medicaid and with small, family-owned businesses.
Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15.
Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, ranging from mental health treatment to maternity care.
The Associated Press contributed to this report.
Contact Jenna Pizzi at jpizzi@njtimes.com or (609) 989-5717.
About the Trenton Health Team
Trenton Health Team (THT) is an alliance of the city’s major providers of healthcare services including Capital Health, St. Francis Medical Center, Henry J. Austin Health Center and the city’s Health Department. In collaboration with residents and the city’s active social services network, THT is developing an integrated healthcare delivery system to transform the city’s fragmented primary care system and restore health to the city. THT aims to make Trenton the healthiest city in the state. Support for the Trenton Health Team was provided in part by a grant from The Nicholson Foundation. For more information, visit www.trentonhealthteam.org.
