Here & Now

Health Care Navigator Discusses Launch of ACA Exchanges

Frederica Freyberg:

According to latest figures put out by the U.S. Department of Health and Human Services, a 27-year-old in Wisconsin with an income of $25,000 would pay, on average, $238 a month before tax credits for a mid-tier silver plan, and $145 after. The same plan for a family of four with an income of $50,000 would pay $861 a month before credits, and $282 a month after tax credits. Now, these are averages based on actual products offered by participating Wisconsin insurance providers, starting next Tuesday. The example I just gave is just the tip of the iceberg. Customer profiles will vary greatly. Now, those entering the vast marketplace will be greeted by licensed navigators working across the state in eight regions. A 27-county region in northwest Wisconsin will be run by the Concentrated Employment Program. Brad Gingras is chief operating officer there and he joins us from Ashland. Thanks a lot for doing so.

Brad Gingras:

Thank you for having me.

Frederica Freyberg:

So are you expecting kind of when the marketplace is open for business next Tuesday, that you will get a lot of people calling up and coming through the door? Or how does that work?

Brad Gingras:

You bet. I imagine there will be, with such a sensitive topic and so many people looking for new health insurance options. We will be open for business and helping to assist in any ways we can, answering as many questions as possible. So yes, we do intend to have more people coming into the job centers and absolutely calling our job centers.

Frederica Freyberg:

And so describe for me, in your part of the state specifically, you just said job centers, how that works. If I live there, where you’re located, and I want personal help with this, what do I do?

Brad Gingras:

Well, the first thing that I would recommend to people is if that’s the case, where personal help is needed, to call in advance. We have limited staff that are trained in the navigator programs, so not all of our staff members are trained. So if that’s the case, we do recommend calling in advance so we can make sure that we have the right person that can assist as needed. As I stated, there is limited staff available and we have many, many people they want to impact through the grant that we received, so even working one-on-one is going to be limited, too. What our intention is to do is to do as much outreach and education as possible in as many different ways as we can through presentations at community centers, within our job centers, at libraries, just to educate as many people about these options as possible. And so to hit so many people, as I stated before, one-on-one, will be a little bit more limited.

Frederica Freyberg:

Do you have a number of how many people you do want to hit?

Brad Gingras:

We do. There’s many people in the 27 counties that we are impacting that will need assistance, and through our grant, we stated that we hope to impact 110,000 in some way. That could be done through mass marketing, through e-mails, through mailings to the home, even through public presentations at the libraries and community centers. So it’s many, many people with limited staff resources.

Frederica Freyberg:

Now, I know that you haven’t even laid your eyes yet on these plans, and we won’t until Tuesday. Is that right?

Brad Gingras:

That’s correct.

Frederica Freyberg:

And so as a navigator, you– you kind of have to understand the plans, presumably, before you can go out and do this outreach and help people, you know, buy into them. But I know there are these different tiers, the bronze, the silver and the platinum. Is it your expectation that the 110,000 people that you hope to impact will fit into one of these categories neatly?

Brad Gingras:

I do believe many of them will. To say all will, that’s very difficult to say. There will be options for many, many people, so the easiest thing to do is to log on to healthcare.gov, set up an account, and start filling out some information about yourself, which can be done individually. It can be done through the help of navigators and other trained certified application counselors. But by simply going through that process, by going on to healthcare.gov, you can learn more about those plans. And through our training, we will not be recommending specific plans to any individual, just sticking to the facts and helping guide them through the process so they can make the most informed decision.

Frederica Freyberg:

How complicated do you think it will be for people actually trying to buy their insurance policies through these marketplaces?

Brad Gingras:

Well, any time you’re dealing with insurance, it can be a sensitive topic. There’s so much to learn, and that can be scary to many people. What they don’t know, they tend– it’s human nature sometimes to be afraid of that. So it’s difficult to necessarily answer in that regard. What I will say is that the web site itself has been created to be as simple as it possibly can. I mean, we are dealing with health insurance, so nothing is as simple as it may appear. And that will be to varying degrees of the individual. Some will be more internet savvy than others. Some may have trouble understanding some of the basic information, and that is what the navigators are there for, to help guide them through the process.

Frederica Freyberg:

You know, and how confusing do you suppose it will be to consumers who are now trying to get into the marketplace for healthcare with lawmakers talking about defunding this law, or delaying it? Do you suppose that some people will hold back and not kind of try to enter in right away because of everything that’s going on?

Brad Gingras:

I think that’s very realistic that they may, based off what information that people are hearing. From our end, we have a project that we intend to start doing. I know, from my personal experience, what’s going on at a federal level, or with legislators has not necessarily impacted what we intend to do. It can be messy, but with that said, that’s not what– We’re not following that real closely to– into the extreme that we have many people that we want to impact. We’re going to stick to the facts, and help guide them as we– as they need, and as we see fit.

Frederica Freyberg:

With less than a minute left, what do you most want people who may be seeking coverage to know heading into it?

Brad Gingras:

Well, it’s something that I would recommend that people do not wait for. Starting October 1st, by logging into or going to healthcare.gov, they can set up an account and start going through the process. It’s a limited time that they have to log in and actually go through this process on healthcare.gov. Do not wait till the last minute. Learn as much as you can, whether that is through visiting your local job centers, visiting your local community clinics, learn as much as you can so you can make the most informed decision about what these health insurance options are.

Frederica Freyberg:

Brad Gingras out of Ashland, thank you very much.

Brad Gingras:

You’re welcome.