Bringing Health Care To The People

Joe DeMattos says the Affordable Care Act will begin correcting disparities  in the health-care system.

Joe DeMattos says the Affordable Care Act will begin correcting disparities in the health-care system.

As the Affordable Care Act is implemented nationwide, millions of uninsured Americans will have a variety of health-care options to choose from. A healthier, insured population will bring a myriad of short- and long-term benefits to Maryland and the U.S.

“Think of the [Maryland Health Benefit Exchange] as Travelocity or Expedia for health care and new health options that are available,” said Joe DeMattos, president of the Health Facilities Association of Maryland.
The hurdle, however, is getting the word out and explaining a complex system to a diverse population that has little or no experience with health insurance.

“There has to be a lot of outreach, and you have to meet the people where they are,” said Tracey Paliath, director of economic services at Jewish Community Services, one of many organizations that will be helping the community understand the new options.

It is estimated that about 800,000 people, 14 percent of Maryland’s population of 5.8 million, are uninsured.

Earlier this month, Lt. Gov. Anthony Brown and Maryland Health Connection, the state’s online insurance marketplace, announced a statewide, multimedia marketing and outreach campaign. The goal of the campaign is to inform Marylanders about the importance of health coverage, plan choices and financial assistance available during open enrollment, which begins Oct. 1 and ends on March 31, 2014. Those who enroll before Dec. 18 will have coverage beginning Jan. 1, 2014.

In addition to radio, print and television advertising, the effort includes a social media campaign and partnerships with the Baltimore Ravens, Giant and CVS. An estimated 180,000 people are expected to enroll in qualified health plans within the first year, and another 100,000 are expected to enroll in Medicaid as a result of the program’s expansion under the Affordable Care Act.

Nonprofit HealthCare Access Maryland is tasked with reaching and signing up uninsured Marylanders in Baltimore City, Baltimore County and Anne Arundel County, approximately 217,000 people.

Kathleen Westcoast, HCAM’s president and CEO, said the goal in the first year is to sign up 18,000 to 20,000 people in the city and about 15,000 in the county. To do that, HCAM and its 16 partners have hired about 107 navigators and assisters. Navigators can sign people up for health plans and Medicaid and assisters can sign people up only for Medicaid. They will be setup with laptops and Internet connectivity throughout the area, so they can register people wherever they are; the community partners will help
determine where the navigators and assisters go.

“We’re relying on organizations that have expertise and tentacles into their communities,” Westcoast said. “We want to tap into their knowledge and expertise.”

Although not a formal partner, JCS is working with HCAM to get the word out in the Jewish community.


Barbara Gradet says health-care changes are long overdue.

Barbara Gradet says health-care changes are long overdue. (Photo Kirsten Beckerman)

“We want to be trained because we know a lot of people will turn to us,” said Barbara Gradet, executive director of JCS. “The resources are out there, but we need all hands on deck.”

She said JCS has been thinking of ways to use JCC facilities as well as its staff to carry out HCAM’s mission.

Paliath, JCS’s director of economic services, said it’s important that the information comes from within the Jewish community since most prefer to get their human services needs met in a Jewish context. To that end, she envisions JCS benefits counselors as well as organizations such as the JCC, CHAI and the Baltimore Jewish Council working on outreach. In addition, synagogues will be contacted to see how the JCS can best work with them to get the word out. The idea is to make sure no segment of the community is left untouched.
“Not everybody who is a member of a synagogue is a member of the JCC,” Paliath said.

The Baltimore Jewish Council held an interfaith informational session in May at the Weinberg Park Heights JCC, where almost 200 leaders across the religious spectrum heard from Congressman Elijah Cummings, Secretary of the Maryland Department of Health and Mental Hygiene Joshua Sharfstein and various other officials.

“I think everybody is looking for ways to get the information out, the correct information and how to best access the exchange,” said Cailey Locklair, BJC’s director of government relations.

Support for universal health care in the Jewish community goes back long before the Affordable Care Act. Locklair said the BJC adopted a congruent policy in the early 1990s.

“The Jewish community felt it was important to ensure that those, regardless of ability to pay, would be able to access a health-care system,” she said.

She said the BJC will tap into its existing network to implement more community-based health programs to ensure uninsured Marylanders get primary care, one of the most important types of preventative care.
DeMattos, whose organization advocates for long-term care providers, said the Affordable Care Act will begin correcting disparities in the health-care system.

“The exchange and the beginning innovations of the Affordable Care Act expand access to care and provide a standard for credible coverage, but that’s only part of the equation,” he said. “The other part of the equation is increasing the overall wellness of a broad cross-section of Marylanders and Americans. We still, today, have incredible health-care disparity amongst different income and ethnic groups.”
Gradet believes these changes are long overdue.

“This country has been struggling with health care a long, long time, and it’s kind of embarrassing where we are in the world,” she said. “With developed nations, we’re way, way behind.”


How The System Works>>

WYPR Series Examines Obamacare and Its Local Impact>>

How The System Works

The Affordable Care Act mandated that states start their own health exchange systems or participate in a federal exchange. The Maryland Health Benefit Exchange (MHBE) was created on April 12, 2011, as an
independent, public corporation responsible for developing and operating Maryland Health Connection, the marketplace.

The Maryland Health Benefit Exchange’s nine-member board includes board chair Joshua M. Sharfstein, secretary of Department of Health and Mental Hygiene; vice chair Darrell Gaskin, associate professor, Johns Hopkins Bloomberg School of Public Health; Therese Goldsmith, commissioner of the Maryland Insurance Administration; Ben Steffen, acting executive director of the Maryland Health Care Commission; Georges Benjamin, executive director of the American Public Health Association;?Jennifer Goldberg, assistant director of Advocacy for Health Care and Elder Law, Maryland Legal Aid Bureau; Enrique Martinez-Vidal, vice president for State Policy and Technical Assistance, AcademyHealth and director of State Coverage Initiatives; Thomas Saquella, former president, Maryland Retailers Association; and Kenneth S. Apfel, professor of practice, University of Maryland School of Public Policy.

The Maryland Health Connection is open to all uninsured Maryland residents, including those with pre-existing conditions. All Americans 18 and older are required to have health insurance beginning in 2014 or pay a fine.
There are 216,587 uninsured residents ages 18 to 64 in Baltimore City, Baltimore County and Anne Arundel County, which is the area Health Care Access Maryland is tasked with reaching. Of those individuals, 33.1 percent have incomes below 138 percent of the federal poverty line, 48.5 percent have incomes between 138 and 400 percent of the federal poverty line, and 18.5 percent have incomes above 400 percent of the federal poverty line.

Under the Affordable Care Act, Medicaid, which is a form of free health care, was expanded to cover all adults under the age of 65 with incomes of up to 138 percent of the federal poverty line, which equates to about $32,500 annually for a family of four. Those making below 400 percent of the federal poverty line, which is about $85,000 annually for a family of four, may be eligible for subsidies.

Maryland residents will be able to use to compare plans, enroll in plans and find out if they are eligible for tax credits or public health programs.

Under the law, plans must cover a wide variety of services, including doctor visits, hospitalization, emergency care, maternity care, pediatric care, prescriptions, medical tests, mental health care and substance abuse treatment. The plans must also cover preventative care at no extra cost, including flu and pneumonia shots, birth control, routine vaccinations and cancer screenings, which include mammograms and colonoscopies.

Maryland Health Connection will offer 45 different medical plans from companies such as CareFirst, Evergreen, Kaiser Permanente and UnitedHealthcare. Of those, 36 of the plans include pediatric dental benefits and 24 offer statewide coverage. There are 20 standalone dental plans from Delta Dental, DentaQuest, Dominion Dental and United Concordia. Twelve of the plans offer family coverage, and eight of them offer pediatric dental benefits only.

According to figures provided by Maryland Health Connection, premiums can range from $73 for a 20-year-old single non-smoker to more than $2,000 for a family of four with varying deductibles. The plans will be categorized based on how costs are shared and will be known as bronze, silver, gold and platinum plans. Bronze plans will have lower premiums and higher deductibles, with silver and gold in between.