Politics & Income, Not Technology, Could Impede Mississippi's ACA Outreach

Khalil Abdullah, Special to The Informer from New America Media | 11/20/2013, 3 p.m.
While much of the scrutiny of the Affordable Care Act has been focused on the technical glitches of the October ...
Representatives from Humana and Magnolia health insurance discuss the challenges of ACA registrations in Mississippi during a health care panel sponsored by New America Media. (Courtesy photo)

Similarly, Mary Anna McDonnieal, Manager of Marketing and Communications with Magnolia Health Plan, explained that her company, promoting ACA enrollment through Ambetter, a health insurance company, active in 46 counties, “has been doing outreach for three years. We’ve established a great resource of faith-based organizations, advocacy groups, non-profits, community leaders, and chambers of commerce. We know a lot of small business – and a lot of businesses out there – where employees are going to need to know about this also.”

McDonnieal said Magnolia has staffed a call center with 42 licensed insurance agents who are especially trained to assist individuals who do not have Internet access but who can get to a phone. Several panelists noted that a common misconception is that a person has to have a computer to get eligibility status from the exchange. The key, they explained, is for Mississippians to get their qualifying information – whether through a paper application or a phone call – into the hands of someone who can then access the exchange on their behalf. The applicant will then subsequently be contacted by mail or phone as to whether he or she can or cannot receive a subsidy and the prices of the policies available to them.

Clearly, access to the Internet is of concern to Nancy Stewart, Director of Operations for Jackson Hinds Comprehensive Health Center. Even with an aggressive marketing campaign like Cover Mississippi, reaching across the breadth of the state into smaller rural communities with negligible infrastructure will be challenging. “Even if it was working,” said, referring to the Mississippi Health Insurance Exchange, “it might not work here. Our people don’t have the technology; some don’t even have libraries and staff to go to do this and they definitely don’t have it at home. They can’t afford food. You know they don’t have the technology at home to sign on-line.”

Communities without a major hospital nearby, for example, cannot reap the benefits of an institution like Jackson’s University of Mississippi Medical Center that, according to Tinniceaa Harris, has trained 41 navigators to assist potential enrollees. Though UMMC’s initial ACA educational effort was to tap consumers as they came through the hospital’s doors, its goal to take the message of ACA benefits into communities is more ambitious. Harris noted that UMMC has partnered with the Mississippi State Department of Health and is working Mississippi State University Extension Services and the Mississippi Hospital Association to broaden the footprint of navigators and raise public awareness throughout the state.

Rigsby, and the Mississippi Center for Justice, emphasized the urgency of the public education effort as it relates to children, given that Mississippi remains one of the 26 states that chose to refuse the federal offer to raise the ceiling of income eligibility to 138 percent of the Federal Poverty Level for its Medicaid population. An estimated 300,000 Mississippians could likely have received insurance through Medicaid, according to Rigsby, had the state embraced that opportunity from 2014 through 2016 to have 100 percent of the costs borne by the federal government; no less than 90 percent in years moving forward.

“These are hardworking Mississippians, store clerks, cashiers, and construction workers,” she explained, using those occupations where a coverage gap exists for workers who often have salaries “where they make too much to qualify for the current Medicaid program and not enough for them to purchase insurance on the exchange.”

“Expanded Medicaid will help Mississippi have a healthier workforce, in addition to bringing 9,000 jobs into the state,” Rigsby contended. She said it was important to continue to press the state’s legislature and governor to bring more adults into health insurance coverage network because “when parents have health coverage, children are likely to be covered as well.”