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Affordable Care Act Enrollment: a Struggle but Worth It

Among the first Chicagoans to apply for health insurance late last year under the Affordable Care Act were Arnie Aronoff and Christine Washington. At first glance, they appear to have little in common. Man, woman. Lincoln Square, Englewood. White, black.

Arnie Aronoff worked with ACA navigators at Jane Addams Resource Corporation to enroll for health insurance benefits.

Photos by Gordon Walek

But they’re representative of thousands of people now breathing huge sighs of relief that their new, affordable health insurance policies will preclude the spiral of personal bankruptcy and poverty that could follow a serious accident or illness. Not that they’re strangers to those threats.

Aronoff and Washington both benefitted from a network of health “navigators” organized by LISC Chicago through its Healthy Communities Campaign. Since last fall, those navigators, working through 21 of LISC’s neighborhood partners, have contacted more than 14,000 potential ACA applicants through 248 outreach enrollment events and good old-fashioned door-knocking.

The enrollment experiences of Aronoff and Washington illustrate the critical role that LISC neighborhood partners are playing in helping get people to the finish line.

In Illinois, more than 61,000 people have enrolled for benefits under the program. Nationally, 2.2 million have signed up.

Not old enough for Medicare, not poor enough for Medicaid

Aronoff, sandy-haired and trim, looks a decade younger than his 58 years. He jogs. He swims. He doesn’t eat meat. That healthy appearance, though, belies significant battles he’s had with his body, starting with melanoma (a malignant skin cancer) eight years ago, followed by thyroid cancer.

Brooklyn-born with a doctorate in history from the University of Chicago, Aronoff had health insurance through his employer back then. But two years ago, after being laid off from his job in corporate organizational development and training, he was diagnosed with a congenital heart valve problem, requiring surgery to the tune of $350,000.

At the time, Aronoff still received COBRA benefits, which provided the same health insurance he had as an employee, though he had to pay the entire group-rate premium himself. But then what?

“I couldn’t buy private insurance because of pre-existing conditions,” he said. “I was uninsurable.”

Barb Silnes, at Jane Addams Resource Corporation, is one of the navigators who've been helping North Siders enroll for health coverage.

He found a temporary refuge in CHIP, a state program for people who’ve been denied major medical coverage due to their health by private insurers and aren’t eligible for Medicare. But Aronoff was paying about $12,000 annually out of pocket for medical insurance and expenses, which wasn’t much more than his adjusted gross income as he was establishing a private consulting practice for nonprofits, including Chicago’s Loretto Hospital and Kings County Hospital Center in Brooklyn.

Website problems

When ACA became the law, Aronoff celebrated. And when registration opened last fall, he logged on to apply for coverage. Or tried to.

“I was using the Safari web browser,” he said. “I called the 800 number. They told me to use Google Chrome. It didn’t say that anywhere.” Not that it helped. He had problems with Chrome, too.

Aronoff eventually completed the application, but more trouble loomed. He was informed that he could buy coverage – which for a person with his medical record is no small thing – but that he wasn’t eligible for a subsidy. And he wasn’t informed why not. His monthly premium would have been $900. Hardly a bargain for one whose adjusted gross income was significantly below the threshold for getting a subsidy.

Enter Barb Silnes, a counselor with the Jane Addams Resource Corporation (JARC), one of 21 organizations working through LISC Chicago’s Healthy Communities Campaign to spread the word about ACA and help people enroll in it. Other applicants, she told Aronoff, were having similar problems. After a few days, it was determined that a computer glitch was the culprit.

“She had me delete my application and start over,” said Aronoff. He did. It worked. With the obsessive zeal he appears to bring to most challenges, Aronoff ran different spreadsheets on the various plan options (platinum, gold, silver, bronze) and settled for the gold plan, which will cover 80 percent of his health care costs. His premium is $441 per month, with a $500 deductible.

He’s happy with the plan. “But,” he said, “the complexity of this is a mirror to what it means to make informed decisions about health care. It’s like being from a different planet. I’ve done a lot of project roll outs, but I’ve never seen anything like this.”

In a pleasant postscript, Aronoff, who before applying for health insurance wasn't aware of JARC and the various services it provides, now does volunteer work for the organization.

Christine Washington, whose part-time job does not include benefits, can more effectively manage her health care as a result of successfully enrolling for insurance under ACA.

CWF to rescue

On the South Side, Christine Washington wasn’t faring much better. Like Aronoff, the Englewood resident had plenty of incentive to get health insurance coverage. And fast. She had a heart attack in 2000, when she was 47. It shook her up, but not enough to stop smoking. That habit didn’t break until 2010, when one weekend, while reading the newspaper and watching television, her right side suddenly became paralyzed. She’d had a stroke, a not uncommon occurrence among family members. About a million people are hospitalized with them each year.

“Not being able to walk really bothered me,” she said. As did the absence of health insurance. What she did have was some savings, thanks to her fiscal discipline and a 30-year career preparing business credit reports for Dun & Bradstreet – work that technology subsequently rendered obsolete. Her part-time job as a receptionist at Chicago Public Schools’ downtown headquarters doesn’t include benefits.

Treatment for the stroke, even paying on a sliding scale at Stroger Hospital, plus rehab at Oak Forest Hospital, nearly depleted her savings. Then, in 2011, she had surgery for gallstones. And there’s the diabetes, the high blood pressure, the eight medications. Washington – tall, regal, fashionably dressed – doesn’t look the part of one who’s been beaten down by illness. Doesn’t act it, either.

“I paid all the bills,” she said, without regret or bitterness. “It took a while, but I have no debt.”

While Aronoff last fall was banging on his keyboard up in Lincoln Square, Washington was doing the same in Englewood – a cross-city duet in frustration. She thought something was wrong with her computer, not the site.

So, prompted by the website, she headed over to the Center for Working Families on the Kennedy-King College campus at 63rd and Halsted. The CWF, run by Metropolitan Family Services, is another community organization working with LISC Chicago’s Healthy Communities Campaign. There, Cassandra Caldwell punched Washington’s information into her computer with similar results.

“They couldn’t do it, either,” said Washington. Caldwell urged her to go home and keep trying. Each day, she did, and completed more and more of the application while government technologists ironed out the website wrinkles.

“It took a while,” said Washington, “but was worth the wait.” She settled on a Blue Cross Blue Shield silver plan, which for her requires a subsidized $74 per month premium. The deductible is $500.

Sheryl Morris, of Jane Addams Resource Corporation, distributes ACA information to CTA riders on Montrose Avenue last month.

What’s ahead

Barb Silnes, at the Jane Addams Resource Corporation, said problems Aronoff and Washington encountered late last year have been largely corrected. “The website’s improved so much,” she said. “It’s a lot easier now and people are enrolling. But our work’s not done.”

She’s spending much of her time following up with people who gave up trying to register in November and haven’t returned to complete the job. Plus, she’s gearing up to help a new wave of applicants likely to show up before the end of ACA’s open enrollment period on March 31.

“Navigators played a key role in helping Arnie and Christine successfully enroll for health insurance benefits," said Dominique Williams, who heads up LISC Chicago’s Healthy Communities Campaign. "And they're playing an even greater role assisting residents in our target communities who don't have web access or basic tech skills. We're confident that, through the work of our neighborhood organizations, more of them will be enrolling by the end of March."

To find a LISC partner agency that can help with health insurance choices and enrollment, download the map and list of Healthy Communties Campaign partners.

See the Chicago Tribune's story about recent enrollment figures.









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