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HealthCare.gov Sign-up Process Especially Daunting for Immigrant Populations
03/21/2014   Reported By: Patty B. Wight

With the deadline to sign up for health insurance in the Affordable Care Act's online Marketplace a little more than a week away, enrollment specialists are trying to encourage as many people as possible to meet the deadline. But not all of the website glitches have been worked out, particularly for those with complicated applications and immigrants are one group that falls into that category.

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 Duration:
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Libby Cummings

At the Portland Community Health Center, enrollment specialist Christian Bisimwa is trying to help Rwandan couple Carine Murebwayire and Bonaventure Mionziema sign up for health insurance. Bisimwa is talking to a healthcare.gov representative over the phone.

"Is his wife a US Citizen, or US national?" asks the healthcare.gov representative. "No. She is an asylum seeker," replied Bisimwa.

Signing up for health insurance as an immigrant requires a lot of triage, said Health Center enrollment specialist, Libby Cummings.

"Consistently, we have encountered exponentially more barriers and more delays with applications for asylum seekers and those with green cards than we have for American citizens."

For one thing there are language barriers. Even though interpreters are available when calling healthcare.gov, Cummings said no one she's worked with has successfully navigated initial instructions in English or Spanish to get to an interpreter. Proving identity is also problematic because the website asks for a credit history- something many immigrants don't have. And Cummings said the website has trouble recognizing immigration status. This is a roadblock the Rwandan couple is facing. They're asylum seekers. They arrived in the US eight months ago with their four children, and their income is below the federal poverty level. They don't qualify for MaineCare, the state version of Medicaid, because of their immigrations status. Instead, they should qualify for Marketplace subsidies, but Cummings said the federal website still bounces their application to MaineCare.

"So we got an incorrect ineligibility determination for these clients," said Cummings. "So what we're going to do is just fill out an appeal."

The appeal buys time, so the couple can sign up beyond the March 31st deadline. But Cummings said there are likely others who have problematic applications and don't know what to do.

"Ya know, since you guys are here applying with me it's ok. But if you were at home or didn't know you could miss it," she said. "I'm worried that we'll have people who will miss this regardless of whether immigration status is a factor, anybody who is applying and doesn't know that this deadline is pretty final will have to wait till next year."

Andre MutekelaCummings said resolving these issues is labor-intensive. It's a process that requires sending in extra documents by mail and making follow-up phone calls, and she say there are only so many applications she'll be able to complete by the deadline. Those who started early will likely fare okay, like asylee Andre Mutekela. After about a three-month process, he finally has affordable health insurance, he said, something unavailable at his job.

"It was hard without insurance and what could happen to me if I could be in accident," said Mutekela. "That was very hard, and I was sad about that."

The deadline to enroll in the insurance Marketplace is Monday, March 31st.

Photos by Patty Wight.

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