The next phase of the Affordable Care Act went into effect this week, with the launching of the online marketplace exchange. Millions of Americans responded by rushing to the site, causing it to crash in D.C. as tensions rose over the government shutdown.
Here in Anchorage, the launch was accompanied by a press conference held at the Alaska Native Tribal Health Consortium. Leading the conference were several representatives from local and regional organizations. In attendance was U.S. Department of Health and Human Services Regional Director Susan Johnson, Val Davidson – Senior Director of Intergovernmental and Legal Affairs at Alaska Native Tribal Health Consortium (ANTHC), Sue Brogan – Vice President of Community Engagement at the United Way of Anchorage, and Nancy Merriman – Executive Director of the Alaska Primary Care Association.
Regional Director Johnson opened with a speech focusing on the “firsts” of the new phase. It was the first day for millions with pre-existing conditions to be included under health insurance, the first day for people to be able to shop the exchange, the first day that new tax credits were available for assistance in making plans affordable, the first day that trained “navigators” were available to help navigate the potentially confusing regulations. She was very adamant that the most important story isn’t the fact that the site has been malfunctioning or that a few people might be falling through the cracks, but that it’s the beginning of important changes in American health care.
Val Davidson’s message was a little more grounded in the practicality of the Affordable Care Act. While most Alaska Natives and American Indians are covered through benefits from Indian Health Services, tribal governments, or (in the case of Alaska Natives) nonprofit ANCSA corporations, these benefits are generally rooted “at home” and are limited in depth of medical specialty. This means that Alaska Natives who travel or require specialized treatment aren’t necessarily getting the coverage they need. The outreach message to Alaska Natives could be summed up as “You’re not losing any benefits, but don’t be afraid to shop around for the extra coverage and call on us (ANTHC) for help.”
Davidson likened the healthcare exchange to the cultural practice of sharing in subsistence, saying that “we need to start thinking about health resources in the same way, that the more people in Alaska who are covered, the more people who are able to take a bite out of that opportunity for coverage, really helps to insure that all of Alaskans will have what they need.” She went on to talk about how the cost of health care was “already here” and that the problem is in whom currently carries the burden of the cost, namely hospitals and those who are already insured. This has been a common theme in arguing for healthcare reform in America.
Informing and registering people in rural Alaska will be the largest challenge that the state will face, but the consortium of organizations seems organized and ready for the challenge. The first place to check is healthcare.gov, or people can call 1-800-318-2596, people can also work through Enroll Alaska or dial 211 and talk to someone at the Alaska United Way. Alaska Natives can also check the ANTHC website for information and a downloadable pamphlet, or they can call the ANTHC hotline at 729-7777 or toll free at 855-882-6842. While Alaska Natives are exempt, they still must file for the lifetime exemption through one of these approved channels. At the local level, communities can check their libraries for informational flyers or visit any of the 25 community health centers, where they can find a certified application counselor.
The cutoff date for signing up is March 31, but Davidson warned that “like applying for the permanent fund dividend… don’t be caught on March 31 at 11:59 hoping that you can get through the process to meet the deadline at midnight.” So mark it on your calendar ahead of Tax Day, or be prepared to pay the consequences.