SCOTT SIMON, HOST:
The government estimates more than 17 million Americans have gotten health coverage as a result of the Affordable Care Act - Obamacare. But more than 10 million who are eligible still don't have it. Some are resistant. Some are unaware. Some are confused. Open enrollment is now underway, and federal health workers are trying to get to those people who are still uninsured. Fred Mogul of member station WNYC reports on the challenges that await them in Newark, N.J.
FRED MOGUL, BYLINE: Recording and mixing music is Vernon Thomas's passion, but it's not his day job. He was a full-time HIV outreach worker. A local county health department outside Newark hired him in May.
VERNON THOMAS: Originally, it was a full-time position.
MOGUL: But then the county made it a part-time job.
THOMAS: They hired two people.
MOGUL: And Thomas lost the health insurance that was the main reason he'd taken the position.
THOMAS: Benefits are more important than the money that you're making.
MOGUL: Thomas has HIV. He gets the medications that bolster his immune system care of a special federal government program, but it doesn't cover anything else. And Thomas says he'd like a little more medical care, like, maybe some doctors keeping an eye on him.
THOMAS: Prostate cancer runs in my family on both sides. My mother and her mother and her brother all had diabetes. My mother had hypertension also. Fortunately, I have low blood pressure. But now they're saying that I have high cholesterol.
MOGUL: Thomas's part-time job doesn't pay a lot, yet he makes too much to get free healthcare from Medicaid. He's eligible for Obamacare, but he says it's too expensive. And Newark rents aren't getting any cheaper. So he goes without and keeps his fingers crossed.
THOMAS: I try not to think about it, getting sick.
MOGUL: Thomas didn't realize his low income qualifies him for generous subsidies that would not only buy down his premium to $100 or less but pick up much of the deductible and other out-of-pocket expenses, too.
Brian McGovern, head of the North Jersey Community Research Initiative, says overcoming misperceptions about Obamacare has been one his staff's biggest jobs.
BRIAN MCGOVERN: It's always been about trust with some of our patients, about getting on insurance in the first place.
MOGUL: Federal health officials are hoping to dispel confusion and enroll more people like Vernon Thomas. Newark has about 100,000 of them, or one-third of the population. Washington will spend more than $100 million on marketing and enrollment nationwide, focusing on northern New Jersey, as well as Houston, Dallas, Chicago and Miami. In all of these areas, many people are eligible for Obamacare but are sitting on the sidelines. Susan Nash from the Chicago law firm McDermott Will & Emery, says for millions of people, health insurance is still too expensive.
SUSAN NASH: These individuals are having difficulty affording food and housing, and so it's a calculus - do I need health insurance? Do I think I'm going to have a catastrophic event or have some large health care expenditures this year?
MOGUL: The government says about 8 in 10 of these eligible but uninsured people qualify for subsidies. But some of them will get only a little help from the government, and others will get none at all. These people will spend hundreds of dollars a month in premiums.
NASH: Yet you're going to have potentially significant out-of-pocket expenses in terms of meeting deductibles and have to do some good research on which providers are in the network.
MOGUL: But under the law, most people have to get insurance or face a tax penalty up to $2,100. And even if people know that, they still might not worry about it. These fines don't actually hit until Tax Day 2017. And for many people, that's just too far away and just too abstract. For NPR News, I'm Fred Mogul in New York.
SIMON: And this story's part of a reporting partnership with NPR, WNYC and Kaiser Health News.
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