Skip to main content









Donation Heart Ribbon
Visit the Midday Edition homepage

Obamacare Health Exchanges Open For Enrollment Next Week

September 24, 2013 1:15 p.m.


Jennette Shay, Director, Government & Community Relations at Family Health Centers of San Diego

Megan Burks, Reporter, Speak City Heights

Related Story: Obamacare Health Exchanges Open For Enrollment Next Week


This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

MAUREEN CAVANAUGH: It’s been a long way for supporters and even opponents of the affordable health care act but the main provisions of Obama care are about to be rolled out to the public. A week from today Americans can begin enrolling. The new health insurance exchange in California is called covered California. Despite the long buildup, most people are still unfamiliar with this new health insurance set up. KPBS has been running a series called second opinion to answer questions about the affordable care act and now there's a new second opinion app available. I'd like to welcome my guests, Megan Burks is speak city Heights reporter and one of the creators of the second opinion series. Megan, welcome to the show.


MAUREEN CAVANAUGH: And Jeannette Shay is director of government and community relations at family health centers of San Diego project, welcome.

JEANNETTE SHAY: Thank you, it's good to be here.

MAUREEN CAVANAUGH: Now, Megan, what actually begins on October 1 for Obama Care?

MEGAN BURKS: So starting next Tuesday open enrollment begins for covered California which is the state run health insurance exchange. So this basically means people can start shopping for new health insurance policies. Those policies will go into effect so until January 1, 2014.

MAUREEN CAVANAUGH: What kind of coverage is available through covered California? For instance is this private health insurance?

MEGAN BURKS: So these plans are from the same providers that a lot of authority so Kaiser, HealthNet, Sharp. But they just are being sold in this marketplace where the marketplace can kind of help us that the cost and also provide subsidies for people who qualify.

MAUREEN CAVANAUGH: So it will generally will be to find out whether or not you qualify for a subsidy to get one of these private health insurance policies.

MEGAN BURKS: If you want to the side cover to see a right now you can go see if you're eligible for subsidy and get an idea of how much things will cost and you can actually purchase one on Tuesday. And you can also find out there if you're eligible for Medi-Cal. So you don't have to be buying an insurance policy but you can also you said find out if you're eligible for the public health plan.

MAUREEN CAVANAUGH: Megan, give us a general sense of who is eligible to just go uncovered California and buy themselves a health insurance policy next week?

MEGAN BURKS: Certainly anybody can use covered California to shop for health insurance policy. But it doesn't necessarily mean that everybody's going to qualify for subsidy. If you are currently uninsured you can go on there. If you have insurance but you maybe want to find another policy you can check it out as well. So really any Californian can have on there and see what's available to them.

MAUREEN CAVANAUGH: Now, this summer you launched a series of answers questions about the affordable care act and about California's health exchange covered California. How many questions have you answered during your series second opinion and what types of questions did you get?

MEGAN BURKS: We been doing this for about three months now so I think a bunch are waiting to be answered of miles and a lot of people are participating and I think the first question everybody asks as a generic, what is I do, how does this affect me, that we drill down and figure out what their health concerns are and I think a lot of people have been really interested in costs it may wanting to do the math to figure out is it going to be cheaper for them to buy health insurance, or should they may be considered paying this find you have to pay starting next year if you don't buy individual health insurance. There's also fine for employers who do not for some employers who do not ensure their employees and that begins in 2015. So actually I got a flight instructor who's involved in this aerospace industry here in San Diego and he wanted to know if some of these businesses should take the fines. So his research Martindale.

NEW SPEAKER: Will small companies with between 50 and 100 employees find it cheaper not to carry the coverage and pay the fine?

MAUREEN CAVANAUGH: What did you tell him?

MEGAN BURKS: With this question whether or not to pay the fine or by the coverage I think a lot of people asked because they really need to know for their bottom line whether they are a family or employer but they also kind of, the fine is $92 for an individual to start and 200 for employees to start. People heard that and thought this is going to get anybody and people will just pay the fine but when I found out is that if you take everything into account, so you look at the subsidies that you may be missing out on if you don't buy insurance if you consider the fact that you do not pay 100% of your place premium you're really talking about saving hundreds of dollars instead of thousands of dollars. I talked, for the father of six who had a similar question for his family, he would, at the most save $400, which works out to about $30 a month. So what I found is that is a values-based decision instead of a hard financial decision.

MAUREEN CAVANAUGH: and is your personal decision that doesn't seem to be any yes or no answer to something like that. You have another question, sample of a question that came through to you during, when you solicit questions for the second opinion series.

MEGAN BURKS: Yeah, so my beat is primarily covering city Heights and city Heights is a very diverse community. Very rich immigrant community. So my very first post question came from Paula (inaudible) and she wanted to know what her mother could expect, her mother is here on a green card so here is Paula.

NEW SPEAKER: So my mom is a permanent resident here, and I'm wondering what kind of benefits she's going to be able to have under the affordable care act.

MAUREEN CAVANAUGH: And what's your answer?

MEGAN BURKS: So in California I should say the entire US, the affordable care act benefits and fines are not extended to people who are in the country illegally. They are extended to people who are here legally, who have legal residents, so Paula's mom is eligible. In a lot of states there's a five-year wait so if you have just arrived you have to wait five years. California now has found a workaround, so in California if you are recently arrived immigrant, you're here legally, you can actually participate in the exchange if you qualify for Medi-Cal. You can't get that through the exchange as well.

MAUREEN CAVANAUGH: Let me bring Jeannette Shay into the conversation. You, Jeanette ran into a lot of people are really sort of out of the loop that this change is coming and the fact that insurance will soon be required under the law?

JEANNETTE SHAY: Sure, absolutely. So we have a team of average workers that are on the streets everyday and I think what they are hearing is that people are just confused. They've heard of Obama care. They know kind of any big picture there is something coming but when you get to the specifics about what it means for them what it means for the family, how would they apply. They are very confused. A lot of questions about cost, what is actually going to cover if they have insurance doesn't mean it's going to change or go away. So basically a lot of confusion. People really haven't taken the time to dig into the details yet of what it means for them.

MAUREEN CAVANAUGH: As family health centers of San Diego region how do you do the outreach?

JEANNETTE SHAY: We found that really one-on-one person-to-person is the best way to do the reach we have a team of outreach workers in the communities that we serve. They're going to the meetings they're going to the community partners. You're talking to people on the street. We set up flyers in the clinics. We are averaging to patients in the clinics, to anyone who's uninsured to kind of flag them so we can hand them a flyer and give a phone call to say would you like to meet with someone? We have certified application of sisters that literally sit one-on-one with the patients, go through the website, help answer any questions they have, figure out what makes the most sense for them and their family. But it's a very personal process as Megan was describing the answers are different for every individual based on their financial situation, how many people in the family, with their employer is doing. See you cannot do one postcard and say this is what it means to you, it's really individual conversations with folks.

MAUREEN CAVANAUGH: Megan, as you're listening to the questions that came in are there any sort of questions that surprised you?

MEGAN BURKS: Yet we recently talked Conrad Harris. He works for an organization called coming homes to stay in city Heights and they help former inmates kind of resettled back into the community. His question was pretty basic. How can he get more information to his clients? A product kind of an interesting facet of this a lot. So let's listen to Conrad.

NEW SPEAKER: The question I have with the affordable care act is that the population which I deal with is, how do they access information to know if they are eligible for the program, do they qualify for the program and what do they need to do to enroll into the program?

MEGAN BURKS: So with Conrad, again, pretty basic question and the answer is you should probably call up Jeannette and put that in touch with his clients. What it brought up is that the affordable care act is going to touch thousands of inmates who are being fast tracked for release under the present realignment program in California. Prisoners are predominantly young, low-income, single males, and Medi-Cal, the public health plan has never been available to them before. It's available to children and to families. Starting next year Medi-Cal's actually going to be available to childless adults. So for the first time this population that we are really all starting to confront in a new way is going to have some extra help.

MAUREEN CAVANAUGH: Megan KPBS has launched a second opinion at the, how do you see this app helping people with their questions about Obama care?

MEGAN BURKS: So like Jeannette said, you start to look at specific things they can start to get confusing but what I found in the series is that a lot of people have not started looking so they don't know the basics because they are so intimidated by the wealth of information that is out there. So, this app is designed to kind of help you figure out as an individual, as a family or as a business person what you need to do, what are your responsibilities and what are your options. And then as you go through the app, Windows specific questions, you can still call me and I will on the Amsterdam free.

MAUREEN CAVANAUGH: Is it free, the app?

MEGAN BURKS: It is if you go to opinion you see it at the top of the page and you can start clicking away.

MAUREEN CAVANAUGH: South Carolina so now I wonder is that the viewer how do you find out answers to these questions? I mean I understand parts of the law are still changing is that right, Megan?

MEGAN BURKS: I have essentially covered California on speed dial now, and I talked to insurance providers, private insurance brokerages, and they are also helpful and so on forms. And a lot of times they just say to me unfortunately the answer is we don't know yet because there are still some things that the White House and the IRS in California is still trying to figure out how they're going to work so for instance instance the employer mandate that employers who have over 150 employees have to cover their employees, that has been postponed. Because they're trying to figure out how that is going to work. I talked to covered California recently for another second opinion. And they told me that they were not quite sure how families who want to keep their child who is going to college in a different region, they were not sure do they need to buy separate policies, or can they all stay on a family plan. So they are still working out the specifics themselves.

MAUREEN CAVANAUGH: Jeanette you run into that as well counseling people one-on-one that there are still areas that are sort of gray and nobody knows how this is going to work.

JEANNETTE SHAY: Absolutely but I will say that there are certainly areas that are great that we do not have answers to but there are a lot of answers that we know and what we found the most is that people really haven't started the conversation so we really want to encourage people to call us, to call family health centers, to use the KPBS app to go on because really for the average family the answers are there in terms of how much is going to cost, how to enroll and what they qualify for and there are a lot of people in the community that are here to help.

MAUREEN CAVANAUGH: Jeanette what about misinformation are you running into that as well?

JEANNETTE SHAY: Absolutely. One of the things recently, the news is that some organizations nationally were charging people for advice so people are scared have to pay for advice and we want to be clear that community health centers like family health centers of San Diego we will help you for free. There is no charge to call and get advice and have you walk through the process that's probably the biggest piece of misinformation lately and there's all sorts of misinformation about how much does the cost, whether it's too expensive and who doesn't qualify. But again, these can be solved simple conversations and we really want to be here to help.

MAUREEN CAVANAUGH: I wonder Megan in getting the questions, soliciting questions, listening to them, what is your sense of the issues that people are most concerned about when it comes to this new healthcare?

MEGAN BURKS: I think generally they are just concerned about making sure that they are not left behind, that they know what they are supposed to do, what October 1 means, with January 1 means. So they are just interested in making sure they are in the know, and beyond that they are very concerned about the cost. A lot of them are very grateful and see kind of a light at the end of the tunnel, that the cost is going to lessen for them and what are concerned that it's going to increase especially with businesses.

MAUREEN CAVANAUGH: I think this is an important point too, Megan, who doesn't have to do anything, make any calls or find out anything people covered under group insurance right now?

MEGAN BURKS: Yeah, people who already have insurance there's a good chance nothing is really going to change too much for them. Especially people who have the employer-based coverage. A lot of these plans are grandfathered in. A lot of them already comply with the law and I always say the general rule of thumb is if your employer is already covering if they are covering it because they want to, so why would they change their mind. I have heard some credit businesses looking at the numbers and thinking maybe I'm still looking out for my employee, but maybe that means sending them to the insurance exchange, but you will know if something's going to change free.

MAUREEN CAVANAUGH: Jeanette, on October 1 will there be call centers I think you mentioned something about call centers where people can get information from family health centers?

JEANNETTE SHAY: Absolutely we have a special line that is set up 619-515-2363 and that is staffed by our certified application assisters that are there to help people information about enrolling. I want to mention there's another group that doesn't have to do anything that suburban San Diego that's covered by the affordable health plan may will automatically roll into Medi-Cal so this is a new group of people that are insured over the past three years through a county plan that will be part of Medicaid so that's a big change for them too. But again with the call-center to call us at 515-2363 we are there to help.

MAUREEN CAVANAUGH: Even though enrollment is next Tuesday people have until the end of December and the open enrollment and extends until next March.

JEANNETTE SHAY: Correct and right between October 1 and December you'll be in a holding pattern insurance kicks in until January 1 but you have until the end of March to enroll but you have to wait until the following year in the fall to reenroll.

MAUREEN CAVANAUGH: I've been speaking with Megan Burke speaks city Heights reporter, one of the creators of the second opinion series and one of the creators of the second opinion map from KPBS and the Jeanette Shay, director of government and community relations and family health centers of San Diego. Thank you both very much.

MEGAN BURKS: Thank you.


MAUREEN CAVANAUGH: Next Tuesday, KPBS Midday Edition will devote a whole hour to the launch of the affordable healthcare open enrollment. We will have an expert on hand to take your calls.