SNOW HILL – Becky Grinath never thought she’d have to traverse five foot seas on a boat to try and get people signed up for health care, but that’s exactly what she found herself doing a few weeks ago.
“I had to go over to Smith Island to meet with many of the watermen who live there,” said Grinath, “it was awfully rough and quite cold on that boat on Tangier Sound.”
When local health care navigators first started to get people enrolled in the Affordable Care Act several years ago, they cast a very wide net. Now, they are sharpening their focus to the people who drive the shore’s most vital industries.
A federal HRSA (Health Resources Services Administration) grant helped the Lower Shore Health Assistance Program enable local health care navigators like Becky Grinath to focus on getting farmers, small business owners, and watermen signed up for health care.
“We were one of 10 national grantees and it is a rural outreach benefits program” said Kat Gunby, program coordinator for the Lower Shore Health Assistance Program, “so this enabled us to allow Becky to focus solely on these three groups of people in our region.”
Grinath says while it took a little while to convince the often stoic and old fashioned craftsman of the land and sea about the merits of the process, but she says it’s starting to sink in.
“It’s about trust in those communities, and to be able to leave the office and go to all three counties and build relationships and make small inroads at a time was key,” said Grinath, “but it’s a still a steady and ongoing effort.”
Grinath quickly found that most of the individuals had similar needs and concerns, both financial and personal.
“Cost was always one of the biggest factors in choosing a plan as all three groups run on very small profit margins,” said Grinath. “They are all essentially small business owners and many of them hadn’t even considered going through the Maryland Health Exchange.”
Website malfunctions, skepticism fueled by political debate, and confusion about the sign-up process were early problems for health care navigators all over the country, but for local navigators, sometimes just finding the people was a challenge.
“The first year we were trying to find the uninsured and we quickly found out that they were everywhere on the lower shore,” said Gunby. “The last two years, we started to focus on different sectors of our community like the hospitality industry, in addition to the focus on small business, watermen and farmers because these industries are the bread and butter of our community on the Eastern Shore, and many of them, had existed without health care for a long time.”
Numbers released last week by the Maryland Health Benefit Exchange (MHBE) chronicled the large spike in enrollment throughout the state, and especially here on the lower shore.
In Worcester County, 5,236 residents enrolled in private plans, which is up almost 60% from a year ago. In Ocean City alone, there was an 84% increase in private enrollment.
In neighboring Wicomico County, more than 10,565 people signed up for private health care plans which marks a 120% increase from a year ago.
Grinath says she personally signed up more than a 125 waterman, farmers or small business owners who didn’t have coverage before.
“I can think of a number of families who ended up saving thousands of dollars a month just by going through the process and navigating through the exchange and finding the right plan,” said Grinath. “But, we are still trying to get the word out that we are available to help them. Some people didn’t know there was a local entity or even a local person that was there to help them.”
Gunby says the focus on the three groups is important, and that focus is starting to yield good results, and those results appear to be building even more for various reasons ranging from earned trust, to aging applicants.
“As people get older, they are more concerned about their health,” said Grinath. “I met a waterman the other day who was not insured and hadn’t been for quite some time, but he was starting to have health problems and we found him an affordable plan that he wouldn’t have been able to get before.”
The manual labor often associated with commercial fishing or farming is also another reason Gunby believes the focus is important.
“Agriculture is a high health risk occupation,” said Gunby. “There’s a lot of stress and strain on the body due to the manual labor, and they end up needing more health care services than other populations or occupations.”
Yet, even though the most recent open enrollment period has ended, and the health care coverage numbers in Maryland are impressive, Grinath and Gunby say the work is nowhere near complete.
“There are doors that I haven’t knocked on yet, and I’m going to keep knocking, and building those relationships, earning people’s trust, and finding them a health plan that works for them,” said Grinath.