Yesterday, Sarah Kliff from the Washington Post’s Wonkblog visited HCFA and Community Catalyst, and here’s her fabulous report: Meet Kate Bicego, the woman who knows how to implement Obamacare.
Kate is HCFA’s Helpline Manager, and, as Kliff reported, she and the other Helpline staffers are the crucial link in turning the promise of coverage into reality:
If anyone can claim to know how best to implement Obamacare, it might be Kate Bicego.
Bicego isn’t affiliated with any university or government agency. She isn’t a household name in health policy. She works in a nondescript cubicle in downtown Boston, on the 10th floor of a nondescript office building.
What Bicego does do is run the Massachusetts health insurance help line. For six years, she’s been the one making sure the state’s health reform law does what it’s supposed to and cover the uninsured.
“Here we are, many years out from [Massachusetts’] health reform, and people still have problems navigating the system,” says Bicego. “They still need our help.”
The Massachusetts health insurance hotline is run by Health Care for All Massachusetts, a non-profit that advocated for the 2006 law. State offices answer basic questions: where to get a form, which agency handles which kind of coverage. There is no government agency, however, to explain how to fill out a complex form, or troubleshoot a dispute with a given agency over a coverage determination. That’s where the helpline comes in.
“If you call Medicaid and say ‘I’m pregnant and I want to apply,’ they’ll send you a form,” says Bicego. “We’re the ones that help fill out that form.”
Even six years into Massachusetts health reform, there’s still significant demand for those services: the help line handled 40,000 calls in 2011 alone. The help line team can now fill out an application for Medicaid and other state-subsidized programs in five minutes flat.
Kliff listened as our counselor Hannah Frigand helped a client:
The scene when I visited the help line’s offices Thursday: A colleague of Bicego’s, Hannah Frigand, is on hold with the state Medicaid office. She’s working on the case of a woman who previously had insurance through her school, but whose coverage lapsed after she graduated. Now pregnant, she had an urgent need for care but was running into roadblocks getting her application processed quickly.
“There’s universal access, but people still transition a lot,” Frigland tells me while she’s still on hold. “Especially in this economy, people are coming on and off of the economy, switching jobs, there’s a lot that’s going on.”
When my half-hour visit to the helpline was ending, Frigland was wrapping up her call with the state Medicaid office. She did reach one person there, but he wasn’t sure if he had the authority to sign off on the expedited application. He transferred Frigland to his supervisor’s voicemail. “We do know he has the authority, but he says he’s not sure,” Frigland says. “It’s frustrating, but we’ll keep on trying.”
Besides helping individuals get coverage, our Helpline also provides crucial feedback to MassHealth and Connector officials, identifying bottlenecks and advising on improvements. Kliff picked up on that, too:
Issues completely removed from health policy can become significant hurdles. Like the time, two summers ago, when a state agency ran out of paper. Government rules prevented the department from ordering more before the end of the month, so health insurance termination notices ended up going out late, a potential disruption in coverage for some.
Bicego and her colleagues have shared these kinds of insights with the federal government as it gets ready to implement the Affordable Care Act. She also meets with the Massachusetts Medicaid department and the Connector, which administers the rest of the state subsidies, to talk about what isn’t working within the state.
“What we’re able to do is take what we learn here and tell them about our experience,” says Brian Rosman, researcher director for Health Care for All Massachusetts. “The best was when the Medicare person asked what the best way to ask about income was. And she was like, ‘I know exactly how to ask people because I’ve done it 10,000 times.’”
HCFA is proud of our Helpline, and the vital role it plays in making health reform work, both here and nationally. You can help, too, by supporting our work. Tuesday, May 8 is our annual fundraising dinner. Find out how you can help here, and attend to meet Kate, Hannah and the rest of our Helpline stars.