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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Are Assisters and Agents Really Needed?

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Question: If signing up for Obamacare is going to be so easy, why are assisters and agents needed?

Answer: A lot of hand-holding is essential to signing up for Obamacare. Covered California is creating streamlined web portal, but the process of completing the an application will be difficult for many. Yes the health questions will be gone, but they are replaced by financial questions. It will be more like filling out a tax return. And just as H&R Block has hundreds of offices and thousands of employees who guide clients through the tax preparation process, so too will Covered California need organizations and knowledgeable and trusted assisters and agents who can make the process understandable and reassuring.


The process of completing the application will be much like doing your taxes; you do not want to screw it up. The last thing you want is the IRS knocking on your door asking you to prove to them why you deserved such a high subsidy. Leave it to the professionals. It costs you no extra money and you are guaranteed to get it right the first time.

RE: LA Times article on 3/16/13, pages B1 & B5 noting there is resistance to backgroung checks and fingerprinting of potential enrollers for fear it may add bureaucracy, be “scary” for potential enroller applicants and may screen out some (esp. male applicants) with “minor” transgressions who may be best able to connect with non-English speaking or “hard to reach” populations. Robert Ross, a board member of Covered California, is quoted as voicing opposition concerns.

If I may offer a comment - I think these opposition concerns are at odds with common sense in the overall success of enrolling participants.

Healthcare enrollers should meet the same standards as present health insurance agents, if not more stringent criteria because presumably they will be dealing with a larger percentage of a vulnerable population, eg low education and English as a second language or non-English speakers.

Why? Because if you skimp on screening such as background checks or fingerprinting, or accept people of either sex with minor “priors”, the temptation to commit fraud will be too easy to pass up for some enrollers who have easy access to vital personal information like social security numbers.

All it will take is just one consumer being the victim of fraud, going high profile on social media or in the news or even by word of mouth, which would invariably be played up persistent detractors of “Obamacare”. And immediately the word will be out that healthcare enrollers are not to be trusted, or worse, all characterized as “criminals” and no one will seek their assistance to enroll, and may remain unenrolled since the fine is cheaper than dealing with identity theft. Even less sophisticated, “hard to reach” populations will decline becoming “suckers” if they perceive using enrollers is a risk.

A comparison that comes to mind, fortunately not universal or well deserved but non-the-less is still prevalent as a stereotype is the TSA screeners in airports. Generally perceived as less educated staff, with many reports of unethical behavior committed by TSA agents becoming public, they are not well trusted by the general public, sad to say. Why would anyone give sensitive information to an enroller held in the same level of “esteem”?

On a lessor note, basing pay on the number of enrollees an enroller signs up potentially lends itself to distorting the sign up process by emphasizing enrollment numbers instead of education. If a potential enrollee has hesitations, an enroller who would like to earn more money may just then skip ahead to the next person to “make the sale”. Again, not cultivating comprehensive enrollment. Perhaps an hourly wage or flat per assignment rate would serve the enrollee population more effectively in the long run, perhaps with a bonus to the enroller later for those enrollees who remain covered for a period of time. Thus would incentivize enrollers to work for getting all enrollees feeling comfortable and committed, knowing that the enroller can earn extra money later via the bonus when perhaps his active enroller services are no longer needed.

May I also suggest that the apparent assumption by the Covered California that a majority of the people without health care belong to the “hard to reach” population my be somewhat inaccurate. Data analysis may reveal that a good many people don’t have health care because individual coverage is too expensive if your employer doesn’t offer coverage. Also, those that are very low income, with or without Medi-Cal can get free urgent care in any public hospital emergency room. And, there are many free clinics, esp. directed at children, who can also get free screenings for some basic care at public schools.

However, back to my main point, hiring enrollers without adequate screening for consumer protection just to get huge numbers of them employed fast to connect with “hard to reach” populations sounds like a short term “penny wise & pound foolish” approach.

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