Nonprofits Coordinating for Obamacare

By: John Dorschner
      With less than two weeks to go before the exchanges open, Miami-Dade's nonprofit entities are talking about working together to get word out about Obamacare and the opportunities for the uninsured to obtain  coverage.

    "I'm feeling encouraged," Daniella Levine, head of the action group Catalyst Miami. Last month, Levine had complained "we are all  up in arms" because South Florida had lost out on a major federal funding effort to pay for navigators, persons trained to help the uninsured get coverage under measures that take effect Jan. 1.

    Levine said a key development was a coordination meeting Thursday in a Florida Blue conference room. The meeting was convened by the Health Council of South Florida, bringing together groups willing to work on the project.

    "All the groups in town were talking about what they are going to do," Levine said. "Most are doing it without getting paid -- a volunteer mobilization effort."

    That meeting occurred after Kathleen Sebelius, secretary of Health and Human Services, visited Miami and trumpeted how much the federal government is doing here to raise awareness in Miami-Dade, which has more than 700,000 uninsured according to the latest estimates.

    Sebelius brought along Karen Egozi, president of the Epilepsy Foundation of Florida, which has received a $637,000 federal grant to train navigators statewide. She told reporters that 50 of the navigators are slated to work in Miami-Dade.

    Levine said the volunteer effort wouldn't be as good as having more paid navigators, but some will become certified application counselors, meaning they can help people sign up through the exchange process.

    Federally funded  health clinics, universities and others are training staff to inform people about the opportunities of getting health insurance through the exchanges, where people cannot be denied coverage because of preexisting conditions. 

    Santiago Leon, a Miami health insurance broker and board member of the activist group Florida CHAIN, agreed with Levine that the county's efforts are at last stepping up. "Between Enroll America, the safety-net providers, the libraries, the schools, and whatever resources we get from the official navigators, I think we will be fine.  It would be way better if we had Medicaid expansion because, as it is, people could be turned down for being too poor (!) and then tell their friends not to waste their time."

    Insurers say the exchanges will work if both healthy and unhealthy persons sign up.  Some critics are skeptical that the healthy -- particularly the young -- will sign up, meaning the insurers will be stuck with a pool of expensive patients.

    HIALEAH A KEY
 
    One key test will be in Hialeah, where the majority of adults 18-64 do not have coverage. Most residents work for small companies that don't offer coverage, and most don't seek policies on the individual market. Daniel Shoer Roth, former El Nuevo columnist, once wrote that many in Hialeah believe they don't need health insurance because if they get sick, "Voy a Jackson."

    Miami's one bidder for navigator funds, the Health Council of South Florida, didn't get a contract. Last month, the group's chief executive, Marisel Losa, said she had "no clue" why the bid was rejected when the Center for American Progress had ranked Miami-Dade as No. 1 nationwide as the community that can benefit the most from the Affordable Care act.

    Asked in an email last week whether she felt better after the Sebelius visit, Losa didn't respond. 

    For persons willing to volunteer to help in the enrollment process, Catalyst Miami is sponsoring a training session on Oct. 4 at Temple Israel. Levine said about 70 have signed up for the training so far.  Register at http://bit.ly/18dGId7. For more details go to catalystmiami.org.

More Poverty After Three Years of Recovery Than During the Great Recession

Congress Should Stop Making the Great Unshared Recovery Worse

Statement by Deborah Weinstein, Executive Director, Coalition on Human Needs

WASHINGTON, D.C.—There were nearly 6.7 million more poor people in 2012 than in 2008, a year deep in the Great Recession. Three years into the Great Unshared Recovery, poverty is worse than in 2008, median income is down, and people are slipping out of the middle class. More than one-third of our nation is near poor—106 million people live below twice the poverty line, one lay-off or crisis away from poverty.

Some programs are working to reduce poverty. Nearly 4 million people rose out of poverty because of food stamps in 2012, of whom 1.67 million were children. But will Congress slash at food stamps despite their effective role in reducing hardship?  This week the House is expected to take up an extreme and damaging bill that would deny food stamps to four to six million people, cutting $40 billion over ten years. Other programs are reducing hardship: the number of uninsured people has declined to 47,951, largely because of the beginning help of the Affordable Care Act and enrollment in Medicaid. House members are intent on undoing that help, too. Unemployment benefits also keep people out of poverty; if there were no unemployment benefits, 1.7 million more people would have been poor. Unfortunately Congress has already cut back both the benefit level and the time these benefits can be collected on the mistaken theory that since the recession is over unemployment is no longer a problem.

More than 16 million children are poor—they are still the age group suffering the most poverty. And there are more than 7.1 million children living in extreme poverty—below $9,142 for a three-person family. Yet 57,000 fewer children will receive Head Start this fall than the year before, with more cuts scheduled in the new fiscal year if Congress does not stop them.  That is just one example of the way Congress keeps low-income people from making gains. Education, housing, job training, unemployment insurance and other cuts combined with ongoing tax breaks for those at the top keep this the Great Unshared Recovery.

The Great Recession may be over for people and corporations at the top. According to a recent analysis, income for the top 1 percent rose 31.4 percent over the past three years. But for everyone else, progress is painfully slow. For the remaining 99 percent, incomes grew by a fraction of a percent (0.4 percent). And 15 percent of our people are poor for the second year in a row – up from 13.2 percent in the Great Recession year of 2008. 

Congress must protect the programs that provide opportunities and prevent harm to young and old alike. Today’s data show the cuts we have made are blocking millions from making progress. Threats of harsh new cuts are exactly what the nation doesn’t need.

First Look:  a table summarizing poverty and health insurance findings.  

Join the tweetchat!

          Check our CHN poverty data page as we keep adding more analyses and state tables

The Arrival of the New Health Insurance Marketplace

  By: Shannon Charles, guest blogger

For millions of Americans today, the idea of acquiring adequate healthcare coverage seems farfetched. With the uninsured rate gradually increasing for adults between the ages of 26-64, does this really provide much hope for the future? Next month, the new Health Insurance Marketplace  will be introduced as a solution to help the uninsured, but before we address this topic, let us examine the past. In March 2010, President Barack Obama signed the health reform, the Patient Protection and Affordable Care Act (ACA), into law. The main goals of the ACA were to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government. The ACA has come under some harsh criticism from those who believe that it will lead to higher healthcare costs, slower job growth, and rising numbers of part-time workers.

October 1, 2013 marks the beginning of open enrollment in the new Health Insurance Marketplace. The Marketplace is a new way to find affordable health coverage that meets your needs. Our main goal as health advocates is to provide assistance to help people select the right health coverage option for themselves and their families. The ACA has outlined three opportunities for consumer assistance which include the following:

·      Patient Navigators

·      Certified Application Counselors (CACs)

·      General education and outreach

Patient navigators educate consumers on health coverage options and assist with eligibility, enrollment, and health plan selection. The navigators are put in place to focus on our low-income, disadvantaged, and hard-to-reach populations. In Florida alone, 2.7 million individuals remain uninsured. In regards to our CACs, these individuals are required to provide information about a full range of Qualified Health Plan (QHP) options. Additionally, they help facilitate enrollment in QHP, Medicaid or Children’s Health Insurance Programs (CHIP). They are also expected to comply with privacy and security standards and disclose conflicts of interest. Although both group’s roles are similar, the two groups differ when considering the fact that the work done by CACs is strictly on a voluntary basis. Patient navigators are compensated through funds provided by the federal government. As of August 15, 2013, the federal government decided which organizations would receive funding to work in the community as navigators.

            The creation of the new Health Insurance Marketplace addresses many important issues that Americans have faced for several years. For instance, most Medicare Prescription Drug Plans have a coverage gap commonly referred to as the “donut hole.” This means there's a temporary limit on what the drug plan will cover for drugs. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. The new Health Insurance Marketplace has worked to eliminate the “donut hole” to allow seniors to purchase name brand medications at lower costs. Another issue tackled is the idea of pre-existing conditions. In the past, health plans were able to deny individuals access to health coverage or raise costs because of a pre-existing health condition. Starting in 2014, health insurance plans are no longer allowed to discriminate against these individuals. The new Health Insurance Marketplace has even made strides to eliminate the gender bias; women are no longer being charged more for health coverage than men. These are only some of the issues addressed in the new Health Insurance Marketplace. Last week I had the pleasure of attending an insightful forum on the ACA, hosted by United Way, that shed some light on several topics. The challenges we currently face include: few people understand ACA, there are limited resources for one-on-one assistance, and general education and outreach. As consumers we must make efforts to become more knowledgeable about the marketplace to help inform others.

            One of the particularly fascinating additions to the Health Insurance Marketplace is the Small Business Health Options Program (SHOP), which is a new program that simplifies the process of buying health insurance for small businesses. For 2014, the SHOP Marketplace is open to employers with 50 or fewer full-time equivalent employees (FTEs). The advantages of this program include:

·      You control the coverage you offer and how much you pay toward employee premiums.

·      You can compare health plans online on an apples-to-apples basis, which helps you make a decision that's right for your business.

·      You may qualify for a small business health care tax credit worth up to 50% of your premium costs. You can still deduct from your taxes the rest of your premium costs not covered by the tax credit.

The SHOP will be very important to businesses as we near the arrival of the new Health Insurance Marketplace. It is very encouraging to see steps being made to solve the healthcare crisis in the United States. Many individuals have been affected by inflated healthcare costs because of a variety of issues that I mentioned earlier, such as: pre-existing conditions, gender bias, and the coverage gap. As the unemployment rate continues to decrease, we will see more individuals being able to join the workforce and select health coverage through their employers. For those individuals who are uninsured due to their unemployed status, it becomes extremely difficult to maintain monthly payments for even the most minimal health plans. It is imperative that we monitor the unemployment rates in the United States because it goes hand-in-hand with access to adequate health coverage, since most individuals acquire insurance through their employers. Hopefully we will see some significant change in the years to come. 

              Considering how much there is still to learn, Catalyst Miami will be hosting a forum in partnership with Florida Blue Foundation on October 4, 2013 from 8am-12pm. The event is titled: Affordable Care: How to get it and how to share it. Stay tuned as we send out more information on this event. If you have any questions, please reach out.

A Collection of Stories in Support of Saving Miami-Dade Libraries

Story #1: A Teacher

Concerned residents of Miami-Dade County are engaged in a fight to save nearly half of its libraries, which are at risk of closure under the County's proposed budget. Should the closures proceed, it would be the largest cut to a public library system in US history. On a rainy Saturday, nearly 300 residents of all ages gathered to support the library system and express their displeasure in the proposed cuts. Given that Mayor Carlos Gimenez has told local media that the "age of the library is probably ending," we have an uphill battle ahead of us.

To support our cause, please sign the online petition, join the #SaveOurLibrary hashtag on Facebook or contribute to the larger #SaveOurLibrary hashtag on Twitter. For more information, visit www.FriendsofMDPL.org

Story #2: A Librarian

In the summer of 2011, the Arcola Branch Library, 49th in the network of 49 neighborhood libraries, opened on the site of  an abandoned drive-in movie theater.  Forty years of blight was finally replaced with county government's $4.525 million investment in the future of Liberty City.  The story below was one of the repercussions of $7.4 million drained from the library system 's 2009-10 budget the year before. The library's money was granted to a list of organizations that provide high end art exhibits  and concert series.  Taxpayers had no say in the decision that library hours and library programs such as free tutoring were being cut.  The 250  library staff affected went quietly.  The public, for the most part, only thought that the library system had hours reduced. Here's how it felt for one of the survivors as he prepares to be a victim of the next tidal wave of 169 layoffs. He will be one of our finest who will be told to leave for good. This is his story:
 

A pat on the back and a kick in the teeth seldom come on the same day.  Although the library staff knew they’d be coming close together. We were waiting for them both.  But not on the same day.  It was supposed to be our day of triumph.  We were opening the new library for Arcola Lakes. We had given one of the poorest neighborhoods a state of the art library that would be envy of the richest.  They loved it.

The people swarmed this palace of self-improvement filled with brand new books, brand new computers, brand new furniture, brand new everything.  In one month we had gone from bare walls and bare floors to this.  Soon, we were helping everyone, from hard-working immigrants trying to keep up with USCIS paperwork to young mothers needing advice on helping their child stop struggling with reading.  And today was the grand opening.

There was the mayor, the county commissioner, our library director and half dozen other VIPS. Several classes of children from Arcola Lake Elementary came with their teachers. Even my old high school teacher, now a school librarian herself, was there to see it.  The speeches were said. The applause, but not the glow from the achievement, faded away.  The mayor shook my hand. He shook all of our hands.  The VIPs left. Everyone relaxed.

And then they came.  They came with the layoff letters:

·      A demotion for my manager

·      A demotion for me. 

·      A termination for my new Trainee. 

·      Transfers for some of the rest.

We were honored for our effort, then scattered to the four winds. All on the same day.

It hurt but until this July I counted myself lucky and felt my fate was hard but someone had thought it necessary to keep the library intact.

The library would go on and I would still able to serve. We would still get the job done.  Mine must’ve been the easiest letter to hand out that day. I could live with this.  But I was sad for my manager.  We had all worked with dogged dedication when things were grim, and with great enthusiasm when they were not.  But more than all the rest, she had poured her heart into that library.  It was not just a building or a collection. It was seen as an opportunity to affect the future course of the community.  She was a great manager.  She deserved better. They all deserved better.

So, we took the severe layoffs two years ago with barely a murmur and little public action.  And this year, we just cannot. We cannot be silent or silenced.

Because then, as bad as it was, only our own jobs were at stake, and not the library herself.  Self-interest is not enough to get a librarian to rally in the streets.  This year is different, like night and day. This time they’re gutting the library and stuffing her carcass with empty promises.  On the outside the library will look almost the same.

But when people go inside to order a book or ask for computer help they will find that little remains but rags and bones.  All too often they will walk up and the doors will simply be closed.

Our county mayor wants to save the “footprint of the library”. A footprint is good to look at but not much else. A footprint is a memory, nothing more.

~Employee 169

Story # 3: A Senior

There are NO words to describe my gratitude for being able to READ books via the Miami Dade Library System.  The “Connections” service has been and continues being a “life saver” for me!  I would probably go crazy were it not for Linda, who usually selects books that are mailed to me regularly!  (She has been super wonderful to me!)

I am a senior citizen, living alone and partially disabled.  Relying on a computer is NOT comfortable for me.  Therefore, reading occupies 99% of my free time, which involves hours, hours and more hours daily!!!

When weather permits, I try to leave my home & using of my walker (a must), I literally push myself to get to the Miami Beach branch library.  Once in a while I read so much that I have to go there because I get ahead of reading the books sent to me! 

I’m 100% positive that there are hundreds (if not thousands) of seniors who depend upon the library system for reading and relaxation.  Not all of these folks are “addicted” to computers. It’s important for us seniors to read in order to keep our brains working

PLEASE, PLEASE do everything possible to insure that our library system remains intact.  There are many other ways for this government to save money than to penalize those of us who are in NEED of libraries.  Government waste is an issue that is not to be discussed at this writing.

Thank you for your time.

Ms. Natalie S. Greenfield, 

tovaemmet@bellsouth.net

Story #4: A Student

Hi, my name is Kevionna Boswell and here is what I have to say about the proposal to defund the public libraries. Please do not close our libraries, even if technology has taken over the world and how we absorb knowledge. We need to think about the kids who don't have technology and whose only resource is to go to the library. There are so many individuals that rely on the public library system to access knowledge and learning experiences. For these reasons, I, Kevionna Boswell, am asking that you keep from defunding the Miami-Dade County libraries.

The Footprint of the Library: A Reflection by Employee 169

In the summer of 2011, the Arcola Branch Library, 49th in the network of 49 neighborhood libraries, opened on the site of  an abandoned drive-in movie theater. Forty years of blight was finally replaced with county government's $4.525 million investment in the future of Liberty City.

The story below was one of the repercussions of $7.4 million drained from the library system 's 2009-10 budget the year before. The library's money was granted to a list of organizations that provide high end art exhibits  and concert series.Taxpayers had no say in the decision that library hours and library programs such as free tutoring were being cut. The 250  library staff affected went quietly. The public, for the most part, only thought that the library system had hours reduced. 

Here's how it felt for one of the survivors as he prepares to be a victim of the next tidal wave of 169 layoffs. 

He will be one of our finest who will be told to leave for good. This is his story:

 

A pat on the back and a kick in the teeth seldom come on the same day.

 

Although the library staff  knew they’d be coming close together. We were waiting for them both.

But not on the same day.

It was supposed to be our day of triumph.

 

We were opening the new library for Arcola Lakes.

We had given one of the poorest neighborhoods a state of the art library that would be envy of the richest.

They loved it.

The people swarmed this palace of self-improvement filled with brand new books, brand new computers, brand new furniture, brand new everything.

In one month we had gone from bare walls and bare floors to this.

Soon, we were helping everyone, from hard-working immigrants trying to keep up with USCIS paperwork to young mothers needing advice on helping their child stop struggling with reading.

And today was the grand opening.

There was the mayor, the county commissioner, our library director and half dozen other VIPS. Several classes of children from Arcola Lake Elementary came with their teachers. Even my old high school teacher, now a school librarian herself, was there to see it.

The speeches were said. The applause, but not the glow from the achievement, faded away.

The mayor shook my hand. He shook all of our hands.

The VIPs left. Everyone relaxed.

And then they came.

They came with the layoff letters.

A demotion for my manager.

A demotion for me. 

A termination for my new Trainee. 

Transfers for some of the rest.

We were honored for our effort, then scattered to the four winds. All on the same day.

 

It hurt but until this July I counted myself lucky and felt my fate was hard but someone had thought it necessary to keep the library intact.

The library would go on and I would still able to serve. We would still get the job done.

Mine must’ve been the easiest letter to hand out that day. I could live with this.

But I was sad for my manager.

We had all worked with dogged dedication when things were grim,and with great enthusiasm when they were not.

But more than all the rest, she had poured her heart into that library.  It was not just a building or a collection. It was seen as an opportunity to affect the future course of the community  She was a great manager.

She deserved better. They all deserved better.

So, we took the severe layoffs two years ago with barely a murmur and little public action.

And this year,  we just cannot. We cannot be silent or silenced.

Because then, as bad as it was, only our own jobs were at stake, and not the library herself.

Self-interest is not enough to get a librarian to rally in the streets.

This year is different, like night and day.

This time they’re gutting the library and stuffing her carcass with empty promises.

On the outside the library will look almost the same.

But when people go inside to order a book or ask for computer help they will find that little remains but rags and bones.

All too often they will walk up and the doors will simply be closed.

Our county mayor wants to save the “footprint of the library”. A footprint is good to look at but not much else. A footprint is a memory, nothing more.

~Employee 169