In Haines, helping locals get health care pain-free

Susan Briles waits at the Haines SEARHC clinic to help locals find insurance coverage. (Photo by Berett Wilber)

Health insurance can be expensive, boring, and frustrating. But for the next five weeks, the federal marketplace is open for people to buy care — and one Alaskan is on a mission to make sure those bad feelings can’t stop good coverage.

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Most people’s eyes don’t light up at the prospect of buying health insurance. Susan Briles is the exception.

“We’re out there making sure that as many people have coverage as can get it,” Briles said.

As an Outreach and Enrollment specialist for SEARHC, she’s holed up this week downstairs at the Haines’ clinic, explaining deductibles, premiums, and co-pays like it’s her job.

Which it is. Briles is in Haines because the enrollment period for the Affordable Care Act just opened: Alaskans have until December 15th to buy health insurance.

Briles’ job got a little harder this year.

“For 2018, my concerns are there’s a lot of people that think we no longer have the Affordable Care Act. Which, we in fact do,” Briles said. “It’s still exactly the same as it was for the prior years. But there’s a lot more misinformation there than there used to be.”

Given the polka-dot geography of Southeast, it’s a logistical challenge to inform people about open enrollment. On top of that, Briles said the federal government cut her advertising budget 90% this year — and the sign-up window was halved.

“When the Affordable Care Act first came into being, we used to have three months to get people enrolled,” Briles said. “Now we have six weeks.”

So Briles is on a whirlwind tour of Southeast to get people covered and clarify misconceptions.

“The framework the Affordable Care gives us means insurance companies have to operate under a much stricter set of rules,” Briles said.

For instance, insurers have to cover pre-existing conditions — in Southeast, that often means diabetes and cancer, she said, as well as things like asthma or high blood pressure. And insurers can’t limit the costs they’ll cover.

Despite those benefits, Alaskans are used to bad news about health care.

The small, dispersed population, high cost of business, and limited competition help make Alaskan’s care some of the most expensive in the nation. After the ACA passed, Alaska’s premium rates have climbed by nearly a third each year since 2014.

Until this year.

I’ve done the marketplace insurance every since it was started. My rates probably dropped 25% from last year,” Beth Fenhaus said.

Fenhaus makes beer at the Haines Brewing Company. She’s not a high-cost patient: she’s young, healthy and has barely used her insurance since signing up four years ago. She’s saving money this year because Alaska got permission to keep running its reinsurance program.

Alaska sets aside a pot of money to pay for its most expensive patients. Premiums are lower for healthy people, so the federal government doesn’t have to pay as much in tax subsidies. Then, the feds can use the savings to reimburse Alaska some of the money it set aside in the first place.

Though Fenhaus hasn’t needed her insurance, she doesn’t regret signing up. She works an active job and skis all winter in Haines, far from any hospitals. Insurance gives her the power to stop worrying.

“I think it’s just kind of that realization you have at this time in your life. You’re trying to concentrate on building a savings, building a home,” Fenhaus said.

Susan Briles would agree. It’s exactly those kinds of worries she wants people to focus on instead of healthcare.