(MCT) – An hour into the Affordable Care Act signup event Saturday morning at Mount Calvary Baptist Church, organizers had fewer than 10 takers for help getting health insurance.
There was hope that some of the scores of people attending the health fair in another wing of the church would heed the "Obamacare" signs and fliers and find their way to the waiting volunteers.
"I know there are people over there who don't have health insurance – that's why they're there, to get free screenings," said Mary Wilson, an outreach volunteer with Tennessee Health Care Campaign, which is co-sponsoring enrollment events all over East Tennessee through the end of March.
With just more than a month left to sign up for coverage through the ACA's "Marketplace," organizers have stepped up efforts to debunk myths about Obamacare and get information to the people who can benefit.
Numbers released last week by the U.S. Department of Health and Human Services showed that, as of Feb. 1, nearly 60,000 Tennesseans have enrolled to receive health coverage through the marketplace – two-thirds of them between Dec. 29-Feb. 1. That's still far short of the 645,000 Tennesseans the Kaiser Family Foundation estimates are eligible to purchase insurance through the marketplace, with almost half – some 387,000 – being eligible for subsidies to help them pay for it.
Volunteers at enrollment events have seen some success stories among the "working poor," such as the 58-year-old self-employed housecleaner who was able to get a plan at a $30-per-month premium, with subsidies. Or the man on a fixed monthly income of around $1,175 who'd been paying more than $650 a month for health insurance through COBRA and was able to get subsidies and pay $60.65 a month for the same coverage.
But they've also faced having to turn away people who can't afford even the lowest level of marketplace coverage but are ineligible for TennCare. Since Tennessee has not expanded Medicaid, a provision of the Affordable Care Act that a federal court has ruled is up to individual states, many low-income state residents fall into a "gap." They aren't in one of the narrow categories of people eligible for TennCare, nor can they get the subsidies that could help them afford coverage through the marketplace.
"It's really heartbreaking," said volunteer Judy Roitman. "Some people who need it the most are not getting any help at all."
About 40 percent who come to local events can't afford the coverage they qualify for because they don't have subsidies, and only a sliver of those are eligible for TennCare, said Derrick Folsom, community outreach liaison for Cherokee Health. The only option is to refer them to self-pay, sliding-scale providers such as Cherokee or Interfaith Health Clinic.
But Bonita Gillespie is one of the success stories. An accountant who owns Gillespie Financial and Tax Service in Northwest Knoxville, Gillespie has self-paid for medical care for more than a decade because with a preexisting chronic health problem – ulcerative colitis – her monthly health-insurance premium would have been nearly $2,000.
Though her income is high enough for her to live comfortably, "I couldn't afford that," she said.
Gillespie now uses a walker because for two years she put off surgery on arthritis-ravaged knees.
"I couldn't afford the surgery and the hospitalization," she said.
Through the marketplace, she was able to purchase a Humana insurance plan accepted by her regular primary-care physician. It took effect Feb. 1. The Silver midlevel plan – the level most Tennesseans are buying – is $497 a month, but because Gillespie qualifies for tax subsidies, she'll pay only $151. She has a $500 annual deductible, a $25 copay for primary-care visits, a $35 copay to see specialists, and her medications, which had been costing her close to $300 a month, now cost $80 a month.
"It's a godsend for me, anyway," said Gillespie, who has made an appointment to see a specialist about her knees.
Despite initial, well-publicized problems with the healthcare.gov web site, Folsom said the enrollment process is getting smoother; in most cases, it's now at 45 minutes to an hour. He advises those coming to an event to set up an email address ahead of time to speed the process. People can enroll by mail or phone also, though it's faster online.
Folsom calls his "determined" team of helpers at Cherokee "the Starting Five" and said that between October 2013 and the end of January, they enrolled 809 people in marketplace plans and assisted more than 4,000.
On March 31, the last day to enroll for this year, they'll set up in the lower level community room of Cherokee on Western Avenue beginning at 3 p.m.
"We're going to be there until the last person leaves," he said.