Erie is one of a number of provider groups across the country that said they were experiencing delays in assisting people with enrolling because they either were still waiting for staff members to complete training or were waiting for them to receive federal certification. Some observers have blamed the delays on glitches in the federal government's training website that have unexpectedly lengthened the times it takes to complete training. Other observers say the delay is due to additional certification requirements established by states where elected officials oppose the healthcare reform law.
Certified application counselors are organizations that have designated staff members to help guide people through the online insurance marketplaces established under the Patient Protection and Affordable Care Act. CAC staff members are required by the federal government to undergo five hours of online training and pass an exam to become certified. Some states require counselors to receive additional training. CACs are not receiving any pay for this work.
“We certainly have been concerned that there's not enough assistance available between the limited amount of navigator grants (another type of enrollment assistance organization), and the fact that we were sort of late in getting this concept of certified application counselor carved into regulation, moving forward on actually registering entities and getting the training up and running,” said Tricia Brooks, a senior fellow at Georgetown University's Center for Children and Families. “Even organizations that would traditionally be in good shape to provide assistance can't obviously start doing that until they're certified.”
Most New York hospitals and clinics could not help uninsured patients shop for health plans during the exchanges' opening days and many won't be able to do so for weeks. That's because of a backlog in state certification that is required to coach consumers through enrollment.
Nevertheless, at the School of St. Ann in the Bronx last week, officials with Montefiore and the Bronx Community Health Network held a public education session to describe the exchange health plan offerings and field questions before about a dozen potential exchange customers.
Hector Martinez, 40, a part-time music teacher at St. Ann who said he's been uninsured for “a long time,” sat in the audience taking notes. “I don't know anything about it,” he said of the new exchange, though he was aware of the penalty for not buying insurance in 2014.
Martinez, an immigrant from the Philippines who received status as a permanent resident three years ago, has sought routine medical care during trips to Manila, where it is cheaper. But such trips are infrequent. In New York, he has relied on community clinics with sliding-scale fees for low-income patients when he fell ill. “I'm so lucky I did not have any problems,” he said.