Under the law, uninsured Americans can shop for new health coverage through on-line marketplaces.
Some states set up their own marketplaces, but other states, like Texas, are sitting it out. That means that starting October 1, Texans will log on to a marketplace set up by the federal government.
Jeness Sherrell, a program assistant for Change Happens, said the money will be used to hire 18 people, dubbed health “Navigators.” These Navigators will educate people who don’t understand health insurance or how the cost-sharing works.
“There are going to be some people who will probably say ‘Oh, I was only going to pay $10,’ Sherrel said. “Well, $10 may be your co-pay, you know?”
On the other hand, many low-income people will qualify for subsidies to help pay for the insurance. And the Navigators can help explain that too.
“It really will be about presenting their options and helping them to see that it’s easier to have a medical home when you have insurance,” Sherrell said. “And when you have a medical home you can develop a relationship with this particular doctor or this particular clinic.”
Navigators will be stationed across the region: in clinics, in pharmacies, at health fairs, churches and block parties.
Another group doing outreach is the nonprofit group Enroll America. Enroll America didn’t receive federal funding, but is conducting its own grassroots campaign.
The group will use digital analytics and other micro-marketing techniques developed during Obama’s presidential campaign.
“We are a very data driven organization,” said Castillo, the group’s Houston organizer. “So when we go out and talk to individuals we are identifying who are the uninsured. We want to go back and follow up with them during open enrollment and make sure they are getting to the marketplace, that they haven’t forgotten about it. Or if they don’t have Internet access, we get them connected, or link them up to a Navigator in the community.”
Texas groups that received federal money include the United Way, the Urban League, and mental health network in East Texas.
Of course, you don’t have to use a Navigator to sign up for the new plans. Anyone who is uninsured can go to healthcare.gov starting in October to look at the plans and the prices.
The subsidies are available for families who earn up to four times the federal poverty level. For a family of four, that’s up to $94,000.
- See if you qualify for a subsidy for your individual health insurance policy here.
- See the amount of the subsidy by using this on-line calculator.
Subsidies are available for individuals and families with incomes between 100 and 400 percent of the Federal Poverty Level. In Texas and some other states, individuals and families with incomes below 100 percent of the FPL are not eligible for a subsidy. This is because those people were originally supposed to be covered by Medicaid, but Texas leaders chose not to expand Medicaid under the law. However, lawmakers could choose to do this at some point in the future.
“It’s rough, it’s really rough,” Castillo said. “And it’s unfortunate.”
“But that was a decision made a state level and we have to live with the consequences of that decision,” he added. “All we can do is help people find care where they can receive it, and if you don’t qualify for a subsidy your options are very limited.”
People in that situation can continue to get medical care at places like federally-funded clinics, or the Harris County health system. Often the fees are based on a sliding-scale or the ability to pay.