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Obamacare: The Website Isn't the Only Problem

Health care law also faces plenty of low-tech troubles

By Maeve Reston

When advocates for the president's health care law strategized about how to reach the uninsured, they knew exactly whom to tap: mothers who could spread the word about the law's benefits, sign up their younger children and nudge their 20-somethings to take part.

But beyond the widely publicized problems with the federal website, low-tech challenges also are complicating that part of the drive to sell the program _ even in California, where the state website is running more smoothly and officials are fully behind the push.

On a recent evening at Dolores Mission in East L.A., nearly a dozen women who help minister to the poor and sick in their parishes met to discuss the work ahead. With organizing help from a faith-based group known as LA Voice, they had collected hundreds of health surveys from parishioners during Sunday Mass. The results, announced by two of the women, sent a murmur of surprise through the room.

More than a third of adults and nearly a quarter of the children at Dolores Mission said they were uninsured. At St. John the Baptist in Baldwin Park, the surveys showed 51 percent, or 2,500 adults and children, had no insurance.

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The surveys gave the volunteers phone numbers for hundreds of uninsured households. But the volunteers have not yet been trained how to answer questions about insurance. And they cannot sign people up; that responsibility rests with trained enrollment counselors. But only 390 of the state's 4,165 would-be counselors are certified and ready to assist people _ leaving the volunteers scrambling to find enough counselors to sign people up at their November church health fair.

There are other problems: The uninsured can sign up over the phone, but most seem to prefer looking at their options and discussing them before making it official. That leaves the website, which is largely working in California, except that for these potential clients, there are not enough laptops available to help explore their options. For some it's more basic than that.

"People aren't going to sign up online by themselves," said the Rev. Samuel Pullen of LA Voice, who brought the women together. Many of the volunteers who gathered at Dolores Mission, he notes, are not Web savvy. "You need an email to sign up. What if you don't have an email?" he said.

Much attention has focused on the high-tech problems of the initial enrollment phase for Obamacare. (Due to website issues, White House officials last week extended the deadline for signups to March 31.) Less notice has been given to proponents' use of the Web to organize their efforts to find those who would benefit from the program.

Through Facebook and social media, groups like MomsRising have recruited 3,000 women nationwide to join their "wellness wonder teams," offering training through webinars and help for women who want to set up blogs to tell their stories.

Enroll America, a nonprofit organization formed in 2010 to support the enrollment push, is supplementing its field program with a $5 million digital campaign targeting minority women. It will use data analytics, similar to those the Obama re-election campaign used to spectacular effect in 2012, to find women online who are likely to be uninsured and capture their attention through ads on websites they visit.

"Based on the information that we have on users and that we collect as they are searching and going about their day online, we can meet them where they are with our message," said Anne Filipic, a 2008 Obama campaign alum who later worked in the White House as deputy director at the office of public engagement. "And when they come to our website (at Enroll America), we can actually tailor our website so it shares specific content, or even specific pictures, based on the demographic."

Filipic's group, along with Organizing for America _ the nonprofit advocacy group formed by President Barack Obama's advisers after the 2012 campaign _ plan a major push before Thanksgiving to encourage women to talk to their adult children during the holidays about signing up for insurance.

Ruth Jaeger, 62, a mother and psychotherapist, is working with other women in her Organizing for America chapter in Marin County to set up a phone bank in November to call women who might be affected by the new law. Earlier this year, her chapter passed out information from a table at farmer's market.

"Marin County is really a high wealth area and we think everyone's got insurance, right? Well, that's not true," Jaeger said. "In this whole process over the past year, it has not ceased to amaze me the number of people who are uninsured."

(c)2013 Los Angeles Times

Daniel Luzer is GOVERNING's news editor.
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