Obamacare Confusion in California Shows Pitfalls of Implementing the Law

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California may be the most pro-Obamacare state in the country, but most Golden Staters who stand to benefit from the new health care law still don’t realize it.

A new survey of 2,000 uninsured Californians by the nonpartisan Kaiser Family Foundation found that 74% of those eligible for federal subsidies to help them buy insurance believe they won’t qualify or don’t know if they will. Of those who will be eligible for the state’s Medicaid program, called Medi-Cal, just over half say they know they can sign up under the Affordable Care Act. Among uninsured undocumented immigrants in California, who won’t be eligible for either program, the survey found that 49% believe they will able to sign up for Medi-Cal and 43% believe they will be able to shop in the state’s new insurance exchange.

Obama Administration officials are betting confusion over the Affordable Care Act will dissipate once new state insurance exchanges officially launch on Oct. 1. Millions of dollars in state and federal funds are being devoted to mass outreach and marketing campaigns to let Americans know that Obamacare is finally arriving in full and, with it, new ways for the uninsured to get health coverage. But there are signs that the rollout of the new federal health law may be bumpy. In addition to a lack of awareness about the new law, even in states like California where support for Obamacare runs deep, some of the new insurance exchanges won’t be launching on schedule. The District of Columbia announced Wednesday that its exchange, DC Health Link, will open Oct. 1 but won’t be equipped to determine if residents are eligible for Medicaid or be able to calculate federal subsidies that will lower the cost of coverage for many. Both are core functions of the exchanges. Similar delays have been reported in Oregon and Colorado.

Attracting large numbers of people to the exchanges, especially the young and healthy, is crucial to their function. If some of the exchange websites experience glitches, there’s a risk that potential customers could be turned off and not return once snags are resolved. A nationwide open-enrollment period that starts Oct. 1, during which individuals and families can sign up for new private-insurance plans and access federal subsidies to cover some premiums costs, will last until March 31. In California, a $45 million federally funded marketing campaign will run during this period and will include a series of television ads touting the state’s exchange, called Covered California.

California was the first state in the country to pass legislation to implement Obamacare in 2010, but marketing the exchange there is more complicated than elsewhere, in part, because of the state’s diversity, says Elizabeth Abbott, the director of administrative advocacy for Health Access, a consumer group in California. The Covered California website lists information in 13 different languages.

The state also has more uninsured residents than any other, with more than 7 million people lacking coverage. The state government and community organizations have received millions of dollars in Obamacare grants to conduct outreach campaigns and help uninsured residents sign up for coverage.

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