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Health & Spirit

Rural areas, already short on health resources, face enrollment hitches

Virginia Anderson, Kaiser Health News on

Published in Health & Fitness

ATLANTA -- Ms. Stella's, a home-cooking restaurant in Milledgeville, Ga., serves roast beef, grilled pork chops, chicken wings and oxtails with 24 sides from which to choose. Last spring, owners Jeri and Lucious Trawick opened a second restaurant in Eatonton, about 20 miles away, and Jeri decided to leave her full-time job to help shepherd the expansion.

But she needed to update the couple's health insurance and went shopping on the Affordable Care Act's online marketplace. Trawick, 43, who considers herself nearly as skilled with a computer as she is with a skillet, found the Affrodable Care Act website daunting.

"It was not exactly user-friendly," she said. Trawick needs specific medications to control her hypertension, and the section on drug coverage left her "confused."

She turned to Insure Georgia, a program funded in large part by federal money to help consumers enroll in the Affordable Care Act. A trained navigator showed her how to compare policies on the website, look at drug formularies and examine differences in prices and provider networks.

"I could have done it without her, maybe, but it would have taken me forever," Trawick said.

This fall, it will be different.

Open enrollment for ACA plans, which begins Wednesday, has been shortened to 45 days. At the same time, funding for navigator programs and other support for consumers has been cut dramatically in Georgia -- by 86 percent -- and across the country.

The number of navigators for Insure Georgia, the nonprofit agency that has received the bulk of federal funding for enrollment efforts in past years, will drop to 21 from 42 last year, said Fred Ammons, chief executive officer of Community Health Works, the parent organization of Insure Georgia.

There is no advertising budget to even inform consumers that open enrollment begins. Ammons said he is concerned that with all the past year's rhetoric among Republicans in Washington about repealing and replacing Obamacare, some people may not even understand that the program is still available.

That could be a problem in Georgia, which, after seeing increased enrollment in the first three years of the marketplaces, experienced a 16 percent drop in sign-ups for 2017 coverage. In some rural counties the decline was as much as 36 percent. Georgia ranks third in uninsured residents, behind only Texas and Florida.

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