HHS official reports both gains and communication challenges with PPACA implementation

Ron Pollack, executive director of Families USA, introduced Anton Gunn at the organization’s Health Action 2013 conference last week by jokingly calling his appearance “the return of the prodigal son.” Gunn, a former Families USA Health Advocate of the Year, was at the Washington, D.C., event to represent the Department of Health and Human Services in his capacity as director for external affairs.

“I want to bring you greetings on behalf of Secretary Sibelius. … She is committed to implementation of the [Patient Protection and] Affordable Care Act; that is her No. 1 priority at the department,” said Gunn, who in 2008 was the first African-American elected to represent his district in the South Carolina House of Representatives. “It’s time to stop talking about it and time to be it.”

Gunn said HHS has been working hard every day since the health care reform act was passed in 2010, and, while much has been accomplished and many have already experienced improved care, a lot of work remains to be done.

“Education and outreach is what we’re doing right now and will continue through March 2014,” Gunn said. He drew attention to the Oct. 1 start date of enrollment in health insurance exchanges as a significant checkpoint, but said already “millions have already received free preventive care” that might have been denied them before PPACA’s passage. The main task now, Gunn said, is reaching the uninsured.

“This process is not easy,” he said. “We know we need to reach younger folks, who don’t know that there are benefits out there for them, and who don’t know the value of health insurance, what the security of health coverage can mean for them.”

Stumbling blocks remain in the form of communication issues and message-handling, and the uninsured are literally all over the map: the states with the lowest rates of coverage (less than 80% of the population) are Texas, Florida, Georgia, California and Illinois.

“We are about coverage expansion … Americans in all 50 states will have access to new marketplaces,” Gunn said. “You’ve heard people use the word ‘exchange’ this morning. Well, guess what? We’re going to use the word ‘marketplace.’ Now, why are we going to use the word ‘marketplace’? Because that actually makes sense to people. ‘Exchange’ doesn’t translate to anything in Spanish, but ‘marketplace’ does. If we want to make the implementation of the Affordable Care Act real to people in this country, we need to recognize and use words that actually make sense to people.”

Gunn noted that 12 million of those who will qualify for health care but do not currently possess it speak Spanish and another million speak neither English nor Spanish as their primary language. Even among Anglophones, though, medical insurance is an intimidatingly complex subject.

“We also know of the uninsured, 25% of them haven’t graduated from high school,” Gunn said. “Literacy is a challenge there. How do you know what a copay is, or what a deductible is, or even what the words ‘pre-existing condition’ mean?”

Although the heavy lifting for such communications efforts primarily will be done by employers, Gunn said the next year is “an all-hands-on-deck situation” at HHS, with the full support of the federal government.