In addition to paid help, the state's new health insurance exchange Covered California is receiving volunteer assistance from cities and counties in signing up Californians for health insurance.
The Long Beach City Council last week authorized the city's health department to apply for status as a "certified enrollment entity."
Staff members in the Long Beach Department of Health and Human Services will receive training to help enroll residents in health plans and serve as a community liaison between Long Beach organizations and small businesses and Covered California.
"We're embracing this opportunity because it fits perfectly with our mission," said Cheryl Barrit, preventive health bureau manager for the Long Beach Department of Health and Human Services.
"Our goal is to improve the quality of life for all our residents and we feel strongly that this will help do that. This is just too good an opportunity to pass up."
More than 22% of Long Beach residents do not have health insurance, according to city officials. The state average is about 18%.
Although Covered California has funding for some community-based organizations seeking to become authorized enrollment entities, it does not offer funding for city or county governments.
"That was definitely a factor in our considering whether this was right for us or not," said Long Beach Health Director Kelly Colopy. "We think it's important enough for Long Beach that we should be doing this whether we're getting reimbursed or not," Colopy said.
Colopy said the new duties will not require extra staff members or add to existing workloads because health department staff members already screen residents for eligibility for several government sponsored programs, including Medi-Cal, California's Medicaid program.
"Part of why this makes such good sense for us is because expanded Medi-Cal -- along with the exchange -- will mean so many more people will qualify," Barrit said. "It makes sense that people like us who are already doing the work should go the extra step to be certified so residents can go directly into Covered California," Barrit said.
"We're already getting a lot of people shopping and asking us what they're eligible for. We can steer them in the right direction now, but once we get the training and are cleared by Covered California, we can actually sign them up. That's right in line with our public health mission," Barrit said.
Other City, County Governments May Follow
Officials at the League of California Cities don't know of other cities considering the same path as Long Beach, but "it will probably be only larger cities that have health departments," said Eva Spiegel, spokesperson for the organization.
"Most cities don't do health and human services so it's not a common issue. Health programs are almost always run by counties in California," Spiegel said.
County governments -- some of them with their own health insurance plans offered through Covered California -- have been getting ready for changes in enrollment and eligibility for months, if not years.
Contra Costa County, one of the counties offering coverage through the exchange, is applying to become a Covered California certified enrollment entity.
"While we do own our own HMO and it is being offered in Covered California, we would be applying for certification no matter what because it's the right thing to do," said Wanda Session, assistant to Contra Costa Health Services Director William Walker. "This is the population that we serve and we have traditionally reached out to low income to help them enroll in coverage. This makes good sense for us," Session said.
"This really is a big opportunity for people like us who have fought for years and years to get people coverage. Now, not only is the coverage there, but for the most part people who didn't used to be able to afford it -- or couldn't even get it because of pre-existing conditions -- can get it now," Session said.
Some Counties May Keep Things Separate
Some of California's 58 counties may elect to leave Covered California enrollment in the hands of the new employees in three new call centers set up in the past several months.
Counties will be busy with expanded Medi-Cal enrollment and will be working closely with Covered California, whether they elect to become authorized enrollment entities or not.
Statewide, counties have added 2,500 workers to handle changes associated with the Affordable Care Act, according to officials at the County Welfare Directors Association of California.
"Because of our existing responsibility to determine eligibility for Medi-Cal -- along with other social service programs such as CalFresh and CalWORKs -- our eligibility workers are different than the 'certified enrollment counselors,'" said Sarah Jimenez, communications and outreach coordinator for the Welfare Directors Association.
Jimenez said city and county health issues are not usually comparable.
"The issue before the City of Long Beach would be an apples-to-orange comparison because cities -- with the exception of the city/county of San Francisco -- do not determine health and human services eligibility and enrollment like counties do," Jimenez said.
Covered California enrollment workers usually ask a few quick questions to identify individuals likely to qualify for Medi-Cal. Likely beneficiaries are directed -- via a "warm handoff" -- from state call center workers to county eligibility workers at one of 32 county service centers across the state.