At least seven D.C.-based LGBT or LGBT-friendly organizations sprang into action on Tuesday to help members of the LGBT community and people with HIV choose a health insurance plan under the controversial U.S. Affordable Care Act thatâs better known as âObamacare.â
Similar to reports surfacing from across the country, officials from the local groups said some of their clients encountered computer glitches on the website for D.C. Health Link, the cityâs online health insurance marketplace or âexchangeâ on its first day of operations on Tuesday.
But all of the officials contacted by the Blade said they were optimistic that the exchange program in D.C. and those in neighboring Maryland and Virginia would soon be operating smoothly and would be an important resource for LGBT people looking for health insurance.
âIâm excited about it,â said Ron Simmons, executive director of the D.C.-based Us Helping Us, an HIV services organization that reaches out to black gay men.
âWe have so many clients who donât have health insurance,â Simmons said. âIf you are HIV positive you need a certain type of insurance, and we are ready to help people choose the best policy suited for their needs.â
Us Helping Us is one of five D.C.-based organizations that received a grant from the D.C. Health Benefit Exchange Authority to recruit members of the LGBT community to sign up for insurance under the Obamacare program. The grant calls on the five groups â as well as another 30 organizations that received grants to work with other constituencies â to help their clients navigate the complicated process of choosing the best possible insurance plan.
The other organizations that received grants to work with the LGBT community on the Obamacare program are Whitman-Walker Health, D.C. Care Consortium, Damien Ministries and Health HIV.
Health HIV, a new national AIDS advocacy organization located in the Dupont Circle area, applied for its grant in partnership with the D.C. Center for the LGBT Community and Westminster Presbyterian Churchâs START program. The START program provides HIV/AIDS-related services with a special outreach to people with substance abuse problems.
âThis is an important opportunity to engage our communities in a conversation about healthcare and for us all to better understand the changes that are taking place in the healthcare system,â said David Mariner, executive director of the D.C. Center.
âOur goal is to help 300 individuals enroll in a healthcare plan and to make the process as simple as possible for them,â Mariner said.
Simmons of Us Helping Us said his group has a goal of helping to enroll 1,000 people on a health insurance plan through the D.C. Health Link system during the nine-month-long grant period.
âWe will have town hall meetings,â said Simmons. âWe will go to the clubs. Our purpose is to help people enroll in the plan best for them.â
Under the Affordable Care Actâs various provisions, Tuesday, Oct. 1, became the first day that the health insurance exchanges opened for business, enabling people to review dozens of options for insurance plans. Consumers may sign up for a plan between now and next March during the programâs first annual open enrollment period. Insurance policies wonât go into effect until Jan. 1.
In order to receive a policy that begins Jan. 1, people must sign up and pay their first monthly premium by Dec. 15, government officials in charge of the program said. People may still sign up between Dec. 15 and March 31, with their policy taking effect at the first day of the following month. After the March 31 deadline, enrollment in the program will be closed until October 2014.
Experts monitoring the system have said the cost of premiums and additional payments such as deductibles and co-payments for doctor visits and prescription drugs vary widely with the different options available. But those familiar with the program say the costs so far appear to be significantly lower than health insurance available in the past in the private market.
Carl Schmid, deputy director of the AIDS Institute, a national AIDS advocacy organization, noted that low-income people may now enroll in Medicaid in the states that have agreed to expand their Medicaid programs under a non-mandatory provision of the Affordable Care Act. D.C. and Maryland opted to become part of the expanded Medicaid program while Virginia declined to do so.
Schmid points out that prior to the Affordable Care Actâs Medicaid provision, which took effect last year, low-income people with HIV who didnât have private health insurance were not eligible for Medicaid unless they were medically disabled with an AIDS diagnosis.
âSo now people with HIV who donât have full-blown AIDS qualify for Medicaid,â Schmid said. âOur goal, of course, is to keep these people healthy.â
Schmid and others familiar with the Obamacare program note that in Virginia and other states that chose not to participate in the expanded Medicaid program, people with incomes below a certain federally defined level are eligible for federal subsidies to help pay for their insurance premiums and co-pays.
Erin Loubier, director of public benefits and senior managing attorney for Whitman-Walker Health, said people with HIV and LGBT people whose income levels may not make them eligible for the subsidies will benefit from another provision of the healthcare law already in effect.
âAnyone living with HIV or another chronic health condition will be able to get insurance,â she said, noting that prior to the Obamacare law insurance companies routinely rejected people with a pre-existing condition.
She said the generally lower prices for premiums through the exchanges will also benefit those who arenât eligible for subsidies.
Under its grant from the D.C. Health Benefit Exchange Authority, Whitman-Walker will provide its clients as well as non-clients the services of trained ânavigatorsâ or âassistersâ to help people choose the best insurance policy through D.C. Health Link. According to Loubier, Whitman-Walker will also provide training for people to become navigators and, similar to Us Helping Us, will reach out into the community to recruit people to sign up for insurance under the Obamacare program.
âThe role of these assisters is critical,â she said. âEven computer savvy people may not be able to navigate the system by themselves.â
Guy Westin, executive director of D.C. Care Consortium, which provides services to people with HIV, said his group is providing navigator services to individuals as well as non-profit community organizations about the enrollment process for Obamacare.
D.C. gay businessman David Franco, owner of the clothing store chain Universal Gear and the real estate development company Level Two, said he was pleased to discover that prices announced so far by insurance companies offering employer health plans for small businesses are lower than previously available plans.
âI was able to see in a matter of 15 minutes with a couple of clicks on my keyboard what my rate would be and compare that to an equivalent plan and see the savings that are offered by different insurance companies,â Franco said.
âSo the fact that youâve got this open, free market has really created this price competition, and itâs going to drop the overall cost for the plan for all of my employees,â he said.
Franco was among several D.C.-area advocates who spoke at a news conference at the National Press Club on Tuesday called by D.C. Health Link and the healthcare consumersâ group Families USA to draw attention to what they consider the strong advantages of the Obamacare program.
Similar to Americans across the country, local LGBT advocates working on the Obamacare program say some LGBT people will likely be surprised and put off when they realize they will be subjected to a $95 tax penalty from the IRS in 2014 if they donât have insurance and fail to buy a policy under the new program. Â The penalty for not having insurance in 2015 goes up to $700.
Federal officials in charge of Obamacare point out that people who already have insurance either through their employer or on the private market and people already on Medicaid or Medicare will not be required to do anything under the new program. Their insurance status will remain as it is, officials said.
Following is a list of the seven D.C.- based organizations known to be providing services to the help the LGBT community and people with HIV access the Obamacare program, including the process of singing up for an insurance plan. Officials with the groups say itâs preferable to call first for an appointment but walk-ins are accommodated when possible.
1701 14th St., N.W.
Us Helping Us
3636 Georgia Ave., N.W.
D.C. Care Consortium
7059 Blaire Road, N.W., Suite
2000 S St., N.W.
2200 Rhode Island Ave., N.E.
D.C. Center for the LGBT Community
1318 U St., N.W.
START Program at Westminster Presbyterian Church
400 I St., S.W.