"It's been a little bit of hurry up and wait," said Paula Smith of Lamprey Health Care, which has centers in Newmarket, Nashua and Raymond. "We've got a lot of things in motion, but it's not really real for us yet."
The center had to wait until last week to access federal training materials, she said. In the meantime, it has been working with other community health centers to coordinate outreach activities to prevent duplicating efforts. Lamprey Health also is putting together posters and booklets for its waiting rooms that include things patients can do now to get ready, such as "gather basic information about your household income" or "make a list of questions you have before it's time to choose your health plan."
At Coos County Family Health Services, waiting rooms in Gorham and Berlin now feature PowerPoint slide presentations informing patients about the upcoming changes.
The new insurance marketplaces will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs they might qualify for. Enrollment begins Oct. 1 for coverage that takes effect Jan. 1. After that, nearly everyone will be required to have insurance or face fines.
Coos County Family Health has used some of its grant funding to hire two new workers who started Sept. 9, and it has begun reaching out to hospitals, food banks and other local social service agencies where enrollment sessions could be held. The agency serves about 16,000 people, roughly 10 percent of whom are uninsured, said director Adele Woods.
"They can come to our office, of course, and get assistance, but we also plan to go out into the community where uninsured folks might be," she said. "We're a small community where word of mouth works well."
Planned Parenthood, meanwhile, has been training nine staffers and interviewing applicants for three new positions — one based in Manchester, one who splits time between Exeter and Derry, and one who will serve the western part of the state, said senior policy adviser Jennifer Frizzell.
Planned Parenthood serves nearly 17,000 New Hampshire patients, more than half of whom are uninsured. They'll be the focus initially, Frizzell said, but there have been discussions about direct outreach on community college campuses and in child care centers. Another target may be small businesses such as hair salons or nail salons, where the workforce and possibly the clientele may be uninsured, she said.
Planned Parenthood also hopes to help train people in other organizations, such as homeless shelters and after-school programs. Librarians in particular have been eager to arrange informational sessions, she said.
"It's unbelievably rewarding to know how many people in the community see the navigator as a critical resource, but it reinforces for me how important it is for New Hampshire consumers to have more access to resources than just what the federal navigator grant would fund," she said.
New Hampshire opted not to run its own online markets, but Democratic Gov. Maggie Hassan's administration has tried to have the state partner with the federal government to manage health plans and provide consumer assistance. Republicans blocked the state Insurance Department from accepting a $5 million grant intended for state-specific education and outreach, and another group that has applied for the money instead is awaiting federal approval.