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AFC to help public navigate Obamacare marketplace
by Matt Simonette

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AIDS Foundation of Chicago is putting the finishing touches on a program it hopes will help LGBT Chicagoans better understand and utilize the Affordable Care Act.

AFC is one of 44 Illinois organizations taking part in the In Person Counselor Grant Program, designed to help uninsured residents navigate their new healthcare options under ACA. The program was made possible by a $650,000 grant awarded in July; AFC is working in tandem with AIDS Legal Council of Chicago, Chicago House, Howard Brown Health Center, Thresholds and the HIV Care Program of the Michael Reese Research & Education Foundation.

The ACA's insurance marketplace is scheduled to launch Oct. 1. According to Daliah Mehdi, chief clinical officer at AFC, that should open up healthcare opportunities for gays and lesbians who have previously been shut out of the insurance market.

"Many people could be denied coverage because of a pre-existing condition, including HIV, and many still can't obtain insurance benefits through a partner because they are not legally married," Mehdi said.

LGBTs often struggle with physicians who might be unfamiliar with their needs or even hostile to them; Mehdi added that the situation can be even worse if the patient is trans. But while the ACA obviously makes no guarantees about the core competencies or sensitivities of doctors, Mehdi did think that the more LGBT patients come through the door, the more comfortable physicians will be treating them.

Many Illinoisans with HIV/AIDS have often been able to utilize funds from the Ryan White Care Act and ADAP to obtain in-office procedures and medications, but "where people run into problems was with out of office stuff such as colonoscopies or emergency room visits," Mehdi said. "The difference now is, (the ACA) means full coverage for them."

A formidable obstacle facing the ACA's stakeholders, however, is that the federal government has released so few details about how the marketplace works or what it will make available. Few people know the intricacies of the plans, or even how many plans there will be. "From what we can tell, it will be anywhere between 60 and 160," Mehdi said.

As such, IPC counselors will have to spend the first few weeks of October studying the logistics of the marketplace. "We'll be looking at them mainly through the lens of an HIV-positive patient and what is best for them," she said. "Our goal obviously is to get it done very quickly."

Thirteen full-time counselors will be deployed to locations throughout the city in order to inform the public of their options and get them enrolled on the spot. The counselors "will be trained above and beyond the state and federal requirements for knowledge about ACA, and those are considerable," Mehdi said.

Among the locations Mehdi said to expect counselors to visit would be Howard Brown Health Center, HIV and STI clinics, state legislator events, testing events and bathhouses, among other locations. "We're looking for anyone who needs us," she added. "Even if someone is holding a house party, we're willing to go to that."

AFC's goal is to enroll at least 8,000 people, and Mehdi said that "the lion's share of the grant funds are going to the counselors' salaries." Open enrollment lasts through March 31, 2014.

Beyond actually enrolling participants, a second challenge is making sure those participants know to actually use the benefits. Mehdi said people who go without insurance for a long time often will need to be prodded to see a doctor even when they finally have available benefits.

The ACA "is about preventive care. Preventive care cannot cost you anything out-of-pocket under this—we want to be sure people know that," she added.

Once the marketplace begins, people interested in utilizing the enrollment counselors should phone (312) 784-9060; someone will be able to direct them to a convenient enrollment event, Mehdi said. Because the counselors will be fairly mobile, AFC won't be able to maintain a calendar of their whereabouts online. Mehdi recommended waiting a few weeks so that AFC officials and counselors had time to become familiar with the myriad options.

The marketplace would likely launch with some hassles but Mehdi was confident that over time the kinks will be ironed out. She predicted that ACA will ultimately have a revolutionary impact on the health of the country, reducing stress about health expenses, for example, and freeing people from holding down unsuitable jobs just to maintain coverage.

"We haven't even really begun to think about the ramifications of a citizenry that has widespread access to healthcare," said Mehdi.

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