As Health Care Deadline Draws Near, Navigators Get Creative

Dec 18, 2013

Cam Nguyen and Sean Murray prepare to talk to cab drivers about the Affordable Care Act.
Credit Mallory Falk

Monday marks the first deadline to sign up for health insurance under the Affordable Care Act. Throughout the country, health care navigators are helping people with the enrollment process. In New Orleans, they're working hard to reach as many people as possible, spending time outside shopping malls, corner stores... even the airport.

It’s a Thursday afternoon at Louis Armstrong Airport and Cam Nguyen is on a mission. She’s here to talk to cab drivers about the Affordable Care Act. Nguyen walks over to ground transportation, approaches a line of stalled taxis, and leans in through driver-side windows.

Nguyen is a health care navigator. She gets paid by the nonprofit Southern United Neighborhoods through a federal grant. Nguyen helps people through the enrollment process: filling out the application, sorting through insurance options, and selecting a plan. She wants to reach people who earn an income but don’t get insurance through their jobs — people like cab drivers.

Nguyen only has a few seconds with each cab. It’s just enough time to lay out basic information and hand over a flyer. She hopes some of the cab drivers will call her to set up an appointment, so she can sit down with them and help get them signed up for health insurance.

Southern United Neighborhoods is one of four organizations in Louisiana that gets federal funding for this work. Nguyen follows strict instructions: keep everything confidential; don’t steer clients toward a particular plan, even if they ask for advice. And she thinks strategically about reaching all kinds of people.

“In this kind of program, especially under the pressure to have a certain number of people signed up by March 31st, people can overlook minorities,” Nguyen says. This is partly because they're harder to reach, with language and other barriers.

So instead of hiring health insurance experts, Southern United Neighborhoods hired people with connections in minority communities; they got hours of online training to learn about the exchange.

Nguyen used to work as an organizer in the Vietnamese community. “I capitalize on a lot of existing relationships that I already had working as a community organizer and tap into those connections,” she says.

A big part of Nguyen’s job is getting rid of the barriers that might prevent people from enrolling — everything from translating applications to bringing a tablet along for homes without internet access.

Leanna First-Arai is another health care navigator. She says every interaction is another outreach opportunity.

“The way I think about it is that I'm always working. Literally everywhere I go,” she says. “I’m going to the grocery store and I’m checking out and so I whip out a flyer and give it to the clerk and ask, 'I know this sounds weird but do you have health insurance?'”

First-Arai compares her outreach strategy to a choose your own adventure story. If someone is hesitant or in a rush, she’ll do a quick 30-second speech.

But, “some people, they'll light up,” she says. “It's like 'Obamacare? I need that! How do I get that?'”

In that case, she’ll go into more detail and set up an appointment. First-Arai says she meets with four or five people a day; each appointment takes about an hour. She says despite all the controversy around the Affordable Care Act, most people are just grateful for an explanation.

“When you boil it down,” she says, “I think a lot of our job is demystifying health insurance.”

Only a few thousand Louisianans have signed up for Obamacare so far. Those numbers are climbing as the first enrollment deadline draws near, December 23.

Meanwhile, Nguyen and her colleagues are getting more creative about outreach. That’s how Nguyen wound up with the cab drivers. She’d tried contacting their employers. No luck.

“But we are allowed to reach out to just the employees, directly,” she says. Her direct approach is paying off. At the airport, some cab drivers promise to call her.

But later a security agent tells Nguyen she has to leave. Nguyen says this isn’t unusual; the same thing happened to another navigator, while talking to school bus drivers. And she won’t let one security agent deter her. With the deadline looming, Nguyen’s determined to reach as many people as possible. She’ll be back at the airport another day, to try again.