Obamacare limbo land for health care navigators

Health and Human Services Secretary Kathleen Sebelius testified before the House Energy and Commerce Committee about the troubled launch of the Healthcare.gov website in October 2013.

Since the exchanges opened on October 1st, Toni Cohen has been in overdrive.

"It has been crazy here," says Cohen. "All the appointments we have. Our days are just packed running here, running there, seeing patients. It’s been nuts."

Cohen -- who works for the community health clinic Project H.O.P.E. -- is one of a handful of navigators in Camden trying to sign up people who are eligible for healthcare.

She has been to churches, farmer’s markets and housing projects. Tomorrow she'll start hitting local businesses and one of Camden’s tent cities of homeless people.

Because healthcare.gov isn’t working well enough to enroll people online, navigators around the country have been forced to switch gears.

In Camden, navigators are resorting to paper applications.

It’s straightforward, says Cohen. But  she’s worried.

"The biggest concern I have of the last five weeks, is that the people who have filled out applications have not heard anything back yet," says Cohen.

One reason: paper applications must be run through the same web portal as the online ones.

One month in, less than 7 percent of the city’s residents who are eligible for Obamacare - have begun the enrollment process.

Maura Collinsgru with New Jersey Citizen Action says there’s a workaround. 

Navigators are directing people eligible for Medicaid to the state’s Medicaid site, njfamilycare.org.

"Because we discovered it was a way for people to enroll now while we await the glitches being worked out with healthcare.gov," she says.

Collinsgru says more than a third of the state’s 900,000 uninsured citizens qualify for Medicaid now that the program is being expanded.

Whether they know about it is another story.

“America is not fully versed on the Affordable Care Act,” says Karen Pollitz, a health policy analyst with Kaiser Family Foundation.

She says as federal officials scramble to get healthcare.gov off the ground, navigators are doing some good old fashioned education.

"You know a lot of people who are uninsured have had years of really unhappy history and have given up on it. And it doesn’t even occur to them that maybe it will work completely differently now," she says.

Pollitz says all the technical problems with the website have depressed enrollment.

But she points to Kentucky -- whose exchange is working well – as proof that when things work, people are willing to sign up.

About the author

Dan Gorenstein is the senior reporter for Marketplace’s Health Desk. You can follow him on Twitter @dmgorenstein.

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