Insuring NY's Last Million

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The Affordable Care Act has had a relatively smooth first year in New York.

The New York State of Health website didn’t run into the extensive glitches that the federal one notoriously did, which could help explain why nearly a million New Yorkers — half of them in the city — signed up for health plans. But the roughly one million New Yorkers who are still uninsured may be harder to enroll.

Elaine Burt, a freelance trumpet player, is one of them. The last time she had health insurance was through the Broadway show Hair, which closed in 2010. But she said the task of signing up through the exchange “felt too daunting,” because as a freelancer, she had to verify her income with each of her former employers. The task was so arduous, she never even found out what plans she was eligible for, or what they cost.

Other New Yorkers didn’t even try to sign up, but community-based groups like Make the Road New York are trying to change that. The group's Bernice Arriaga visits food pantries, nail salons, and anywhere else she might find the uninsured in Brooklyn. One fruitful spot is North Bushwick, where more than one in four lack insurance.

Arriaga directs people like twenty-two-year-old Luis Bonilla, who said he’s never even heard of Obamacare, to Make the Road New York’s office, where a “navigator” can help him through the sign-up process. Navigators are currently based at 33 organizations throughout New York, and they’ve helped contribute to the success of the exchange.

But many of the last million uninsured may not even know they can sign up, let alone where they can get help. Claudia Calhoon, who works for the New York Immigration Coalition, said that’s particularly true of the state’s immigrant population. She said unfounded fears of deportation may deter immigrants from enrolling.

“They may not want to sign up with a program that’s offered by the state, because they might not understand that the state cannot share their information,” she said.

Another big obstacle to signing up is language. Over 1.8 million New Yorkers need translation help, and although a Spanish-language version of the exchange has launched, the New York State of Health website was only in English during the first year.

Money may still be the biggest factor determining how many people sign up for health insurance in the second year. For most New Yorkers, health plans are now more affordable than they were before Obamacare. For Elisabeth Benjamin, with the Community Service Society of New York, that bodes well for the future.

“Our insurance prices on the individual market…dropped by 53 percent,” she said. “We went from Bergdorf’s to Filene’s here.”

Between the less expensive premiums, lower requirements for Medicaid, and increased penalties for not signing up, Benjamin is optimistic about enrolling the last million.

“I think we’re going to have another banner year,” she said.

But what really matters is whether the uninsured ultimately see health insurance as a good deal. For her part, musician Elaine Burt is willing to take another stab at finding out what it might cost her, but perhaps with the help of a navigator this time.

“Maybe if I could sit down with someone that is very familiar with the process and might have some ideas, might have some tips on how to get through it without so much red tape, that might know how I could get my monthly costs down," she said. "I’m actually happy to try again."