ICHS community advocate Aleksandra Posekova helps connect the community to resources and answers at Bellevue Crossroads Mall. • Photo by Michael B. Maine

Many still need help understanding health insurance. With the Affordable Care Act, more people than ever have the opportunity to access affordable health care. Sadly, many are still not taking full advantage of their entitled health benefits.

“I didn’t even know I could be eligible for health insurance as I’m not a citizen,” said Nina, a young Russian immigrant and mother, who did not wish to share her last name. Nina was recently at the Crossroads Mall in Bellevue asking International Community Health Services’ (ICHS) community advocates about health care and community resources for her family.

According to 2016 data from the National Center for Health Statistics, 25% of Hispanics were uninsured compared to 15% of African-Americans, 8.6% of whites, and 7.5% of Asians. The low reported number of uninsured Asians can be misleading however, because it masks lower enrollment for recent immigrants. A person’s lack of understanding can be costly.

“Many people end up filing for bankruptcy because they lack medical insurance,” said Aleksandra Posekova, ICHS community advocate. “Unfortunately, many immigrants find health insurance complicated and confusing. Deductibles, co-payments, and out-of-pocket maximums are difficult concepts even for those who work in health care. It is understandable they are overwhelming for people new to the marketplace.”

The underlying issue is one of health literacy—the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions. Enrollment in a health insurance plan, particularly a government-funded or subsidized plan, is already complex and only made more so through differences in language and culture. An estimated 80 million people in the United States are impacted by a lack of health literacy that results in a lower level of care.

“People get stressed choosing a health insurance plan,” said Posekova. “They have no confidence in their ability to make such an important decision for themselves and their families.”

“We really had no idea on how to go about doing this,” Nina said, shaking her head. “If Aleksandra hadn’t worked with us, we may have never gotten around to it.”

Nina underscores what Posekova and her colleagues at ICHS ultimately seek to stave off—those who choose to avoid enrollment altogether because of a lack of health literacy. Such failures represent potential losses in individual and community health, as well as ultimately undermine the insurance marketplace.

Fortunately, trained, in-person ICHS navigators work in clinics and out in the community to provide in-language, culturally-attuned assistance, and education. They help recent immigrants and others determine eligibility, sift through the choices to compare plans, and complete paperwork and enrollment. They try to make an intimidating, multistep process less scary.

“I understand how difficult the process is for people and have even seen the same family up to three times before they have the confidence to select a plan,” said Posekova. “They often ask the same questions and I tell them that they are not alone and most people have similar questions and concerns. It’s great that we have so many navigators speaking Cantonese, Vietnamese, Mandarin, Korean, Russian, Spanish, Punjabi, and Somali. It’s much easier to understand in your own language.”

“As soon as we got our social security numbers and work authorization cards we enrolled into health insurance plans,” smiles Nina. “Now, I am working in a daycare and my husband will soon start work. I am so grateful for this help from ICHS.”

November 1 is the start of the fifth open enrollment season—the period under which qualified applicants can sign up for health insurance under the Affordable Care Act—ending on December 15.

“This year, the open enrollment period is only six weeks long, instead of 12 weeks. We are strongly encouraging people to start earlier than in past years,” said Posekova. “Qualified health plan enrollees will automatically be enrolled in a plan that is most similar to past enrollment. However, plans have changed and all people are encouraged to shop for the plan that best fits their health care needs and budget.”

ICHS navigators and in-person assisters are available to help community members at each of ICHS’ clinic locations. For more information, call ICHS at (206) 788-3700.

About ICHS

Founded in 1973, ICHS is a non-profit community health center offering affordable primary medical, vision and dental care, acupuncture, laboratory, pharmacy, behavioral health, WIC and health education services. ICHS’ four full-service medical and dental clinics—located in Seattle’s International District and Holly Park neighborhoods; and in the cities of Bellevue and Shoreline—serve nearly 29,000 patients each year. As the only community health center in Washington primarily serving Asians and Pacific Islanders, ICHS provides care in over 50 languages and dialects annually. ICHS is committed to improving the health of medically-underserved communities by providing affordable and in-language health care. For more information, please visit: www.ichs.com.

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