Issue:  Vol. 48 / No. 7 / 15 February 2018

Health care enrollment to start


LGBT Community Center Executive Director Rebecca Rolfe said the center is part of a statewide collaborative on distributing information about the Affordable Care Act.(Photo: Rick Gerharter)
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Beginning Tuesday, October 1, people across the country who don't have insurance will be able to enroll in health care coverage.

As part of the Affordable Care Act, the national health care reform, which becomes effective January 1, almost everyone will be required to have insurance. Income-based assistance will be available to help people pay premiums.

For months, officials have been urging people to enroll in Covered California and get access to care. The state-run program was brought about by the ACA and is designed to expand access to health care to millions of people. The open enrollment period that begins in less than a week ends March 31.

In a White House forum September 12 to launch the Out2Enroll education campaign, Valerie Jarrett, a senior adviser to President Barack Obama, said that as of Tuesday, "for the first time," millions of people who don't have coverage "will be able to sign up for affordable, quality health care."

"Being LGBT is no longer a pre-existing condition," said Jarrett. People can get care when they need it "as opposed to waiting until your symptoms are so acute you go to the emergency room."

Under the ACA, people who are living with HIV or AIDS and other pre-existing conditions can't be denied coverage.

But the enrollment process may be intimidating for some.


Outreach to LGBTs

The San Francisco LGBT Community Center is part of a statewide collaboration that's reaching out to LGBTs to educate them and encourage them to enroll in health care.

"A lot of people are very confused about what does this mean? What's going to be available to me? ... We see ourselves as an important link to people getting the information they need to make good decisions," said Rebecca Rolfe, the community center's executive director.

Most of the people the center works with are very low- or low-income, said Rolfe.

The LGBT center's role includes educating people about their options, answering basic questions, and collecting people's contact information. The center will make information available at its front desk.

Additionally, when people enroll in programs at the center, staff will be screening for whether they have health care "and what their eligibility for subsidized care is," said Rolfe, who said that the center hasn't been tasked with actually enrolling people.

In an email, Dr. Dawn Harbatkin, executive director of Lyon-Martin Health Services, said that her agency is hoping to work with the center to get people enrolled.

The work involving the community center and several other organizations is being funded by a $1 million outreach and education grant from Covered California. Kate Burch, who's managing the grant, is the director of the LGBT Health and Human Services Network for the nonprofit Health Access.

What people without insurance should most know is "they are most likely going to be able to get insurance starting in 2014," said Burch, either through Medi-Cal, which is for low-income people, or through Covered California, "where they'll be able to get subsidies to help them afford paying for insurance."

For LGBTs who already have insurance, especially those who have individual insurance not provided by an employer, "they should know they have the option to find new insurance. They have the option to shop around now," she said.

Burch said her main concern is that "not enough people know" about the available opportunities.

"There are still so many people who haven't heard about the health care reforms and aren't really aware they can get insurance or shop for new insurance that will be cheaper" starting in October, she said.

The Pacific Center for Human Growth in Berkeley is also part of the collaboration to do outreach and education work. As part of its efforts, people from the center have visited events like Oakland's LGBT Pride festival earlier this month.

Leo Brown, the center's program coordinator, said, "A lot of people have misconceptions about health care in general, getting insured. A lot of people don't know what the new laws are, essentially, so it's pretty much just a big vacuum of information." People's questions have included, "How much is it going to cost?" and "What's going to be covered?" said Brown.

He said that he and others don't give people price quotes, but "I personally feel the change will cover most Californians. I do think that they have set things up in a fashion where essentially everyone can be covered. You have to go really out of your way to not be covered once the new year starts."

Brown acknowledged that some people, such as immigrants who entered the country illegally, will still not be eligible for coverage.

He believes that state officials "will be offering some assistance to people who aren't documented," but it's unclear what that coverage would look like.

Overall, Brown said, "I would say that people don't really have anything to lose from this. It's a win-win. It's better to be insured than not."


Presidential adviser Valerie Jarrett is helping the administration roll out the Affordable Care Act.

National leaders encourage enrollment by LGBTs

Separately from the Covered California grant, the Center for American Progress, the Sellers Dorsey Foundation, and the Federal Agencies Project recently launched Out2Enroll, a campaign meant to inform LGBTs about the new coverage options and encourage them to enroll.

At the campaign's launch earlier this month, Jarrett, the Obama adviser, spoke of the importance of educating people about health care reform's benefits.

"This comes down to talking to people who you know and trust you, and talking to them about why it's so important they sign up for health insurance," she said.

One of the goals of those ramping up Covered California is to see younger people purchase health insurance. Under the ACA, young adults can stay on their parents' health insurance until they are 26. After that, they will need to purchase insurance if, for example, it's not offered through their employer. The new health care law relies on large numbers of young, healthy people purchasing insurance to offset the expenses associated with health care for those who are ill.

Jarrett made special reference to young people, who may think they're invincible.

"People do get sick," she said. "They do get into accidents."

Health and Human Services Secretary Kathleen Sebelius also spoke at the event.

"One in three lower income LGBT adults in America don't have health insurance," said Sebelius. "One in three. We are talking about a community that can be hugely and beneficially impacted by what's about to happen."

She also highlighted disparities in care, saying that her agency is working with the Centers for Disease Control and Prevention to collect data on sexual orientation and gender identity.

"We have to be able to measure what's happening in order to understand what's happening" and "target interventions," said Sebelius.

For more information, visit or call (888) 975-1142.


For more on how the ACA will affect people living with HIV/AIDS, see this week's Guest Opinion.

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