- The Washington Times - Monday, January 15, 2018

Armed with scarves and Google maps, a hearty crew of Obamacare “navigators” and volunteers paused for a pep talk before they swarmed a D.C. neighborhood in near-freezing temperatures.

Their mission? To root out the city’s uninsured and steer them toward an Obamacare program, despite President Trump’s claim that it’s already dead and must be replaced.

“Especially with all the challenges we’ve seen at the federal level, it’s even more important that we let people know they still have the opportunity to sign up,” D.C. Council member Brandon Todd, a Democrat, told canvassers.

While Obamacare enrollment is a distant memory in much of the country, the bluest areas are still hitting the pavement. They have sign-up periods well beyond the six-week enrollment that Mr. Trump allowed for the 39 states that rely on the federal HealthCare.gov site.

Obamacare customers in Massachusetts have until Jan. 23 to pick a health care plan, while state-run exchanges in the District of Columbia, New York and California extended sign-ups through the end of this month.

They have a shot — albeit a long one — to close the gap in enrollments after the federal exchanges came up 500,000 short in Mr. Trump’s first go-around, compared with the last year under President Obama.

It’s more than pride or an effort to show up Mr. Trump. Obamacare sorely needs an influx of young and healthy people to make the economics work in the long run. Without them, premiums will soar and insurers may flee the program, leaving fewer choices and even higher costs in what analysts have dubbed the death spiral.

In addition to shortening the federal sign-up period, the Trump administration also cut outreach and advertising, leaving Obamacare defenders working their ground game.

“I think it’s awesome that D.C. extended its period of enrollment,” said Kelly Szafara, who works for a health care startup and joined Saturday’s canvassing team as a volunteer. “I want to make sure as many people take advantage of that as possible.”

The D.C. exchange says it is on track to match last year’s enrollment period, which also lasted 12 weeks, though volunteers are hoping for a surge in the final week of enrollment.

Exchanges in Washington state and Minnesota wrapped up their enrollment seasons over the holiday weekend and, based on the latest counts, are poised to surpass last year’s totals.

In the District, activists used the holiday weekend for the third of four planned canvasses.

Community outreach specialist Kishan Putta marshaled the troops, divvied up manpower and assigned streets in a Northeast slice of the city.

“We’ll take Chillum,” he shouted to a squad downhill as the canvassers scattered like daylight trick-or-treaters.

Bounding from house to house, Mr. Todd clearly was in his element. He gleefully recounted how he knocked on 18,000 doors during his 2015 campaign to fill the ward seat vacated by Mayor Muriel Bowser.

Locating the city’s uninsured isn’t easy, though. Many people in the District are covered through jobs, the city’s generous Medicaid program or retirement benefits they had accrued as federal workers, particularly in the bedroom communities of Northeast.

The city’s uninsured rate is down to about 4 percent, or 27,000 people in a city of roughly 690,000.

“It absolutely is a good problem to have, but we want to close the gap,” Mr. Todd said.

Many residents weren’t home Saturday, didn’t answer or — cracking the door slightly to keep their heat in — said they were already covered.

Exchange workers said that is OK. Everyone knows a nephew, a friend or someone from church who isn’t uninsured, so they are “flooding the zone” with door-hanger reminders and brochures to make sure people know about the deadline in two weeks.

Mr. Todd said he persuaded an entire family last year to put on their coats and go to an enrollment event at a local barbershop after he knocked on their door.

“Sometimes people procrastinate and say, ‘Oh, I’ll get it done, I’ll get it done,’” he said. “They need that nudge. They need a reminder.”

Canvassers who fanned out Saturday said they interacted with two residents who weren’t insured and planned to follow up with in-person assisters. A third made plans to renew coverage at an enrollment center.

It’s unclear how long Mr. Obama’s legacy initiative will survive, at least in its current form, under Mr. Trump, as Republicans mull whether to replace the law with state block grants, trim the program or leave it alone.

The tax cut bill passed last year axed the individual mandate that forced Americans to hold coverage — though that doesn’t kick in until next year.

But the Trump administration has taken a number of steps to tighten the program, making it less generous to customers but, federal agencies say, more logical in its operations. For example, customers were required to pay their first premiums before the start of the year, avoiding the situation in past years when people signed up — boosting enrollment numbers — but failed to pay and were quickly dropped from the rolls.

Mr. Trump also decided to cancel cost-sharing reductions that reimbursed insurers for covering low-income customers. Insurers responded with higher premiums.

Some states said those Trump moves were reasons to have a longer enrollment period this year.

“The additional time is helpful — not only for people without coverage, but it also is helpful for current members,” Massachusetts exchange spokesman Jason Lefferts said. “Some people will see large premium increases because of the end of CSRs, and some may need time to make a decision for 2018.”

Even as Republicans try to reel in Obamacare, it is more popular than ever in the view of the public — particularly in the deep-blue District.

“It should be maintained,” said Alison Brooks.

The Riggs Parks resident argued that Republicans intent on replacing the law spent eight years demonizing Mr. Obama’s program instead of helping people understand what it’s supposed to do.

Ms. Brooks said she was insured through her employer, though a neighbor, Zita Ndam, said she just signed up for Obamacare.

Previously on Medicaid, she received a formal notice saying that because her income had gone up, she should seek a plan on the exchange so she could qualify for taxpayer subsidies. She bought a Kaiser Permanente plan that took effect Jan. 1, though she doesn’t know if it’s the right fit.

“I can’t tell,” she said from her porch, noting it was her first time paying for insurance.

Ms. Ndam will start to find out soon, however. She has a doctor’s appointment on Tuesday.

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