Effort to educate North Dakota's uninsured begins

James Macpherson, Associated Press

BISMARCK, N.D. (AP) -- Almost $1 million in federal money will be spent over the next several months in North Dakota targeting state residents who have no health insurance. The message: Get a policy if you can afford one or face penalties. If you can't pay for a policy, the government will help.

It's part of a marketing blitz that is part of President Barack Obama's health care law that requires most people to have insurance starting Jan. 1.

The federal government is slated to award $600,000 in so-called "navigator" grants for marketing and outreach in North Dakota, where an estimated 74,700 people are uninsured. In addition, $329,467 is going to health care centers in Beulah, Turtle Lake, Fargo and Northwood to help get the word out.

North Dakota, like many GOP states, is not contributing monetarily to the marketing campaigning. North Dakota's Republican-led Legislature reluctantly voted this year to expand Medicaid to cover more uninsured residents of the state.

North Dakota's Medicaid program now covers about 65,000 people a month. With the expanded eligibility, an additional 20,000 to 32,000 people — mostly adults without children — will be added to the program. Under the health care law, the federal government would cover the full cost of expanding Medicaid through 2016, with the state's contribution rising in stages to 10 percent.

Maggie Anderson, director of North Dakota's Department of Human Services, said her agency will help get the word out on the new law but hasn't come up with a plan.

"We will be doing outreach but we just haven't defined what it will look like at this point," she said.

Agency spokeswoman Heather Steffl said much of it will rely on unpaid advertising and networking. "We are a small state and word of mouth really does work," she said.

That may not be enough, said Donene Feist, executive director of Family Voices of North Dakota, a nonprofit advocacy group based in Edgeley that hopes to be awarded some of the federal grant money for health care outreach and marketing.

"It's not going to be an easy task finding these people," Feist said. "It's going to take the work of everyone to find them."

North Dakota's share of federal grant money for outreach is second-lowest in the nation, behind Wyoming's $914,232, records show.

"We're used to being at bottom of barrel in population and money," said Lori Garnes, an associate professor at Minot State University. "But I think we can do a really good job with that little bit of money."

Garnes has helped craft a grant application for the navigator money that would be shared with a coalition of advocacy groups across the state to educate people about the Affordable Care Act. The plan calls for hiring four workers who would be located in Williston, Dickinson, Minot and Fargo, who will do everything from knocking on doors to visiting libraries, businesses and health clinic waiting rooms.

Media advertising also will be purchased and educational fliers are slated to be stuffed in with utility bills, Garnes said.

The U.S. Department of Health and Human Services said its grants to four North Dakota health care centers will allow the hiring of six additional workers to help people enroll in health insurance coverage. The agency said the centers have 16 sites that served 31,435 patients last year and 27 percent of them were uninsured.

"The goal is getting people information," said Darrold Bertsch, chief executive officer of the Coal Country Community Health Center in Beulah, which is getting about $74,000 in grant money from the federal government for outreach. "We can't force them to enroll. We have to encourage them."

Bertsch, who also is the CEO of the Sakakawea Medical Center in Hazen, said federal grant money would be used to hire two additional workers to help with health care outreach in the region. Workers at his clinic also will do "in-reach," surveying current patients who may be uninsured or underinsured to make certain they are aware of the new law.

"The only thing worse than not having insurance is qualifying for insurance but not knowing about it," Bertsch said.


Follow James MacPherson on Twitter at http://www.twitter.com/macphersonja