From Poverty to Opportunity Symposium: Promoting Access to Health Care in Hard to Reach Communities

by Sara Nassof

From Poverty to Opportunity Symposium Series Part 4Panelists:

Moderator: Marjorie Cadogan, Executive Deputy Commissioner, New York City Human Resource Administration’s Office of Citywide Health Insurance Access


In this session the panelists, Health Care Navigators, discussed the organizations that they represent and their mission to raise awareness about health care. A health care navigator is a person or organization that is trained to assist persons in obtaining and learning about health care options available to them in the Marketplace. All Health Care Navigators who presented on the panel represent organizations that specialize in assisting New Yorkers in enrolling in medical health plans. Moreover, all of the organizations specialize in reaching hard-to-reach populations.

In New York, more than nine million people are currently enrolled in either Medicaid or a private insurance program. Approximately 500,000 of these participants in health insurance are residents of New York City. The panelists discussed the history of health insurance in New York City and how the role of Health Care Navigators was developed. Today, Health Care Navigators help residents of New York City take advantage of available programs and enroll in health insurance.

The panelists all agreed that the best way to get people involved in the discussion of health insurance starts with identifying the needs of the family or individuals, and then following through with these individuals and families to target their needs as they may change with the passage of time. The panelists also promoted the idea of getting individuals and families involved in the process through continuous education on what is available and what the Affordable Care Act actually requires. The panelists utilize innovative techniques of communication to foster education and reach out to community members. Some of these techniques include: practical concepts such as contacting community members at hours when they will be available to talk (instead of during typical work hours, for instance), opening the discussion with providers to target what issues they are experiencing with their patients and informing clients that consultations with a Health Care Navigator are optional.

The panelists identified several areas that the community and individuals have addressed as issues regarding their access to healthcare. These areas include cost, fears of lost privacy, fears that the government is monitoring bank accounts and taking assets, and understanding terms and provisions surrounding their healthcare benefits. The panelists highlighted the idea that it is crucial for individuals to understand what they are purchasing and get the answers to some of the common questions that people have such as: “if I get sick, will my premiums go up; what is the difference between the plans that I can choose from?”

The panelists utilize several different techniques to help people feel comfortable with their healthcare plan selection. One of crucial points highlighted during the panel discussion was that looking at what the individual and/or family needs, the cost of the services, and what is available is paramount. It is important to look at what prescriptions the individual currently takes, what types of doctors they currently seek services from, and if there are facilities that prefer their healthcare plan. It was encouraged that participants and community members investigate their options and understand the idea that just because it may be the cheapest plan does not mean that it is the worst plan, or that the plan will not be sufficient for their individual or family needs.

If an individual does not sign up for insurance, there is an option to pay the penalty for not being in compliance with the Affordable Care Act. The penalty for individuals in 2014 is either $95.00 or 1% of their income, whichever number is greater. The panelists also introduced the idea of The Basic Health Option, which is supposed to be available in 2016. This would be a new health insurance product that is targeted to meet the needs of those individuals who are in need of health insurance and do not qualify for Medicaid or Medicare, but also find the current plans to be too expensive.

Open enrollment for private health insurance will run from November 2014 to February 2015. It is important to speak to an enroller or a Health Care Navigator about options. For those already enrolled in the program, it is important to continually update personal information as many life-changing events can impact the costs of insurance.