When Amanda Whiddon graduated from the Loyola Law School in May she extended her student health insurance through October, expecting to have a job and medical coverage by November.
She didn’t.
Her insurance coverage ended in October and, with a pre-existing medical condition and an uncertain employment future, “every time I got in the car, I was like, good God don’t let me crash,” the 25-year-old recalled during a recent telephone interview.
“I was scrambling to get to the doctor and get prescriptions filled before my insurance ran out.”
She went without any insurance coverage for two months. “I was afraid to be around anyone, because I didn’t want to catch anything that might mean a doctor’s visit.”
Eventually, she was hired part-time as a law clerk at a Los Angeles labor law firm, and was able to explore health care options with the Ven. Joanne Leslie, archdeacon and a long-time public health care professional who helped secure an $87,000 diocesan grant for education and outreach about Covered California.
“I talked to her because I didn’t know if I was going to end up getting employer coverage or not,” said Whiddon, who also serves part-time as the young adult ministry coordinator at St. John’s ProCathedral in Los Angeles. “I had talked to her a little bit about Covered California.”
Covered California is a health care marketplace that offers state residents assistance in determining affordable health care options. It is the state’s implementation of the American Health Benefit Exchange provisions of the Patient Protection and Affordable Care Act. The law is important to Californians because it provides financial assistance or subsidies to help individuals and small businesses pay for health insurance.
The marketplaces, including Covered California, offer one-stop shops for consumers to compare health insurance plans and purchase the plan that works best for them, their family and their budget. They can also determine if they are eligible for Medi-Cal, which was expanded in the state; about 1.4 million people are expected to be newly eligible.
By 2014, about 2.6 million Californians will be able to access financial assistance through Covered California to pay for their health insurance, according to the website.
Leslie said the diocesan grant was obtained through Community Health Councils (CHC), a nonprofit, community-based health education and policy organization.
“All of these outreach and education contracts were supposed to start in July 2013 and run through the end of 2014 so that they would inform people during this initial enrollment period and over the summer and continue to inform people in the fall when enrollment opens up again,” Leslie said in a telephone interview with The Episcopal News.
“The target population was the working poor,” said Leslie, a CHC board member. She said the diocese is serving as a subcontractor through CHC to provide education and outreach.
Shelley Weitzel is the diocesan outreach and education coordinator for Covered California.
“I go out and do forums at congregations that request them and at day schools, food pantries, and I refer people to an enrolling entity that will actually enroll them,” she said. The first gathering was held in late August at St. John’s ProCathedral; since then she has traveled the diocese discussing health care options and helping to make Covered California’s one-stop shopping user-friendly.
“When everything launched Oct. 1 there was a lot of confusion,” Weitzel said. “A lot of people thought the Covered California website was the federal site and they were skeptical. Some people thought it was an insurance company and not a portal to shop for different insurance plans and to compare prices.
“My role was to provide overall clarification, not to get into the nitty-gritty of the Affordable Care Act (ACA). I tell people it’s not a perfect program but at least it’s a start for folks to be able to acquire some affordable health care.”
Said Weitzel: “I provide people with a general overview of what Covered California is; how to navigate the website; how they can qualify for a subsidy. I would bring my iPad with me to events and they could plug into any plan to see if they qualified and many learned they would get a government subsidy and that was great news for them.”
During more than 35 outreach events Weitzel received a range of questions, from parents asking how to obtain coverage for their children aging out of parental policies to Medi-Cal questions.
“I’ve talked with people in their 50s who’ve never been able to afford health care insurance,” Weitzel said. “They are incredibly grateful. I talked with a woman in Barstow who had a 22-year-old son and she had never had health care for either of them. We did her numbers and was going to get coverage for $39 a month for both her and her son.”
There were also “wonderful stories about people realizing something is available for them now that they can afford,” she said. “It makes me feel good instead of them winding up in the emergency room trying to deal with something after it’s too late. I’m happy that now folks can go get those annual check-ups.”
Weitzel also made some referrals to Gerti Garner, a 27-year Pasadena employee benefit consultant, who helped enroll them. As of November, about 777,000 individuals were in the processing of enrolling in varying health programs through Covered California, she said.
“We work primarily with employers but we also help individuals,” Garner said. “Since the whole health care reform, we have reached out in that area because we knew a lot of people would need help.
“A lot of people we’ve helped don’t have computer access, especially people who have not had insurance — this is a whole new world for them,” she said. “They need somebody to help them understand the difference between a PPO and a HMO or exactly what you’re looking at when you’re talking about a deductible and out-of-pocket maximum, that kind of thing.”
Her advice for consumers: ask questions; make sure you understand differences between plans based on individual and family needs: HMOs (health maintenance organizations) versus PPOs (preferred provider organizations); basic plans versus catastrophic coverage.
“Whatever plan you have, even if they have a high deductible, your preventive care, for women’s pap smears and mammogram, there’s no charge to the patient,” she said.
Garner shepherded Ravi Verma, 62, a fellow All Saints, Pasadena parishioner, through a website process.
“My insurance kept going higher and higher, I thought Covered California was a chance to lower my rates, I contacted Shelley, to see if I was eligible, actually,” said Verma, a spiritual director who said the website wasn’t always user-friendly.
Then he contacted Garner. “I couldn’t get on the website and I’m an educated guy. I know how to do all that stuff but it was such a maze.”
Garner “helped me fill out the forms, and sign up. I’m signed up, getting a subsidy and it all worked out very well. It was incredibly helpful. Being an independent contractor doing the kind of work I do, everything helps.”
Because of pre-existing medical conditions “it is very challenging to get insurance,” he said, adding: “I could not go without insurance. I am very grateful that the diocese is providing help. It is so important this is being offered. I wish there were more people doing this. I’m grateful and thankful.”
So is 25-year-old Whiddon, who ultimately enrolled in a Blue Shield platinum plan that fits her needs because of lower co-pays and out-of-pocket costs.
Leslie, who holds a doctorate in public health, said offering education and outreach as a diocesan service is part of honoring the baptismal covenant’s call to respect the dignity of every human being.
“In a sense, it is part of our call to support people and, too, in a lot of health issues and I certainly find this in Covered California, people are a little bit confused and sometimes understandably a little bit mistrustful. I think people tend to put more credibility in information they receive through their church.
“The church can play a very valuable role for members of its congregations in providing information to them that will help them protect their own health and that of their families, whether it’s how to plan for end of life care or how to get health insurance or how to prevent various chronic diseases,” said Leslie.
“One of the first conversations I had with a woman at a forum at St. John’s in August … she was looking for coverage for her husband who was older and whatever her situation was, she wasn’t able to cover her husband. She had individual but not family insurance.
“We looked it over and it looked like it was going to work for her husband. Afterwards, she said why are they saying in the news that it’s so bad, this looks really helpful to me. I tried not to get too political … I just said that I’m glad you’ve come here, where you could get reliable information.”
Open enrollment closes on March 31 and will re-open again in October. The diocesan grant will continue through the end of December 2014. For more information, contact Shelley Weitzel at sweitzel@ladiocese.org.