California plans to deploy 21,000 people across the state to sign up consumers when enrollment in the health insurance exchange begins Oct. 1. The squads of trained, government-paid helpers will be armed with the know-how to untangle the complexities of insurance coverage.
In addition, the state is on track to open three call centers staffed by 1,200 customer service representatives who will explain the 2010 health care law and guide callers through their health insurance purchases. Those to be hired will be fluent in multiple languages, including Spanish, Cantonese and Vietnamese, according to state officials.
Effective sign-up is key for the Obama administration as it seeks success in the final phase of implementation of the law in 2014, and that means troops on the ground. Some states probably will fare better than others. California was the first state to create its own state-run health insurance exchange after enactment of the law. “Covered California,” as the exchange is called, is further along when it comes to organizing the advisers who will be providing guidance and information.
The challenge in the Golden State is huge. Some 2.6 million people are expected to be eligible for federal tax credits to help pay for their insurance policies, and there’s another 2.7 million who earn too much to qualify for subsidies but still may be signing up for coverage. The target population lives in a mix of rural and urban counties, with hundreds of thousands of people in Southern California alone who might enroll, according to exchange documents.
To reach out to Californians, “in-person assisters,” as they’re called, will be hired, trained and certified beginning this summer. They will work either as individuals or in association with an organization such as a city government agency, Chamber of Commerce, trade organization, labor union or religious group. More than 3,000 organizations are expected to participate.
Some issues continue to confront the state board that runs the exchange. Should there be fingerprinting and criminal background checks run on the assisters, given that they will have access to sensitive information such as Social Security numbers? Should the assisters partner with retail stores and conduct sign-up sessions in the aisles? How many days should training for the assisters take, and should they do it in person or via computers?
The pay isn’t bad, depending on how fast applicants are processed. California in January received $673 million in federal grants to pay for its exchange functions, including the helpers. Assisters will be paid $58 for each new person they successfully enroll, with $25 for annual renewals.