Immigrants still face health care enrollment snags

Immigrants and others trying to prove their citizenship and identities to enroll in health insurance still face some of the problems they had during the last open enrollment, according to those helping them sign up.

Most people in the 37 states using the federal exchange can complete a relatively short application, but immigrants have to use the still-complex, longer form and deal with a multi-stage process of proving their status and identities.

Identity verification is done through credit history on HealthCare.gov and for some states with their own exchanges. That creates problems for many low-income people, especially those who haven't been in the USA long enough to have credit cards or loans.

"Anyone who doesn't have a long credit history can't get through the initial part of the application, and some don't have any credit history at all," says Angel Padilla of the National Immigration Law Center, which works with groups around the country that enroll immigrants. "A lot of these people we are talking about do not have time or resources to spend on the phone to get this resolved."

Identity verification was a problem for many people who were in the USA legally during the first enrollment, so the Centers for Medicare and Medicaid Services says it simplified the process, including adding interpreters for more than 200 languages and expanding the list of documents that can be used for identity verification.

"We are always working to improve the consumer experience and will continue to educate and clarify, where necessary, the identification verification process," says CMS spokesman Aaron Albright.

CMS says it will have 40% more call center employees — from 10,000 to 14,000 total — helping consumers with HealthCare.gov starting Monday in advance of the Feb. 15 deadline.

Elizabeth Colvin, director of the nonprofit Insure Central Texas, says she sometimes has to keep calling the call center back until she finds a representative that can help get her clients through the process.

Unlike Colvin, Laurie Zimmerman, an insurance navigator with Enroll Quad Cities in Davenport, Iowa, deals with very few immigrants, Still, she has seen identity verification ensnare even USA-born consumers without credit histories. One client in his late 50s who always used cash gave up on signing up for insurance last enrollment period because he got so frustrated with the verification process, Zimmerman says.

When he tried again in November, his application wouldn't go through again and the credit agency handling the enrollment identity verification said there was nothing it could do. So even though the call center told her twice during the first enrollment period and once this time that it couldn't help enroll the man, Zimmerman tried again and got a supervisor on the phone. She was told "we could have signed him up over the phone."

Gisella and Oscar Tomassini had already successfully verified their identities when they showed up at Foundation Communities enrollment assistance center in Austin Wednesday night. But they couldn't log on because the system was down and then when it came back up, it froze them out of the process while their application was being updated. They were at least relieved to learn they were eligible for subsidies to bring their monthly premium down to $40.

Nora Cadena, spokeswoman for Foundation Communities, says it has been more difficult to get on HealthCare.gov on weekends leading up to the Feb. 15 deadline, underscoring the need for consumers to move as quickly as possible now.

Despite lingering challenges, "Compared to last year, this year has been awesome," says Zimmerman.

You just need to know how to get around the roadblocks.

"People doing this on their own may reach a barrier, not know how to push past it and give up," says Colvin. Navigators "can help them get past it."

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