Americans now have unprecedented choices for health care coverage, with today’s opening of the individual insurance marketplace under the Affordable Care Act.

But despite all the news about the federal law, many people still don’t know that they can sign up for discounted insurance, experts say.

In Maine, efforts to inform the public that a key provision of the Affordable Care Act is under way have been stymied. There has been little on television to let people know about the health insurance marketplace, and a lack of visible signs on buildings where people can enroll in person – a service especially needed by people without Internet access.

Twenty percent of Americans – about 60 million – don’t have Internet access, and families that earn less than $50,000 a year are not as likely as others to be online, according to the Pew Internet and American Life Project. Those “working poor,” including the self-employed and part-time workers without insurance, are a major target as the federal government tries to enroll as many people as possible to reduce the ranks of the uninsured.

The Maine Bureau of Insurance projects that 5 percent to 8 percent of the state’s population will sign up for the subsidized insurance in 2014.

People can enroll online or in person, but they first have to know that they can sign up.


“People who know about (the marketplace) and understand it on any level are very excited. But people’s understanding of it is relatively low,” said state Rep. Sara Gideon, D-Freeport.

On Monday in Freeport, Gideon hosted an informational session about signing up. A similar event is planned for 11 a.m. Tuesday at Bell Buoy Park on Commercial Street in Portland.

The Portland area has nine locations where people can walk in and sign up for insurance, including the county health department, community health centers and the Opportunity Alliance office at Monument Square in Portland.

Although 125 federally funded “navigators” and many health advocacy groups are working to enroll people, signs to let passers-by know that they can sign up for benefits there are lacking.

The publicity campaign could have been more robust, said Alyson Cummings, communications coordinator for the Maine Health Access Foundation, which started the website to help people learn about the Affordable Care Act in Maine and find places where they can enroll.

“I’m embarrassed to say that a lot of materials for signs and promotional materials are out of stock,” Cummings said. “(Federal cutbacks) and politics have bitten into the ability to get the word out.”


The sign-up period for benefits in 2014 runs from Oct. 1 to March 31, so Cummings said there’s still time to correct those problems.

“There’s a long road ahead of us, but eventually people who need to find out will find out,” Cummings said.

On the eve of the sign-up period, there were glitches with the rollout. The official website for the Affordable Care Act lists only two sites in Maine, one in Bath and another in Sanford, where people can visit to ask questions, get help in other languages and sign up for insurance. The website includes 94 sites statewide.

Cummings said she doesn’t know why the official site isn’t as up-to-date, but the foundation is working with the federal government to update it.

Because the Affordable Care Act was adopted with the assumption that states would choose to operate their own insurance marketplaces, federal grants to get the word out were not set aside for states, like Maine, that asked the federal government to take over setting up their exchanges.

Many states with Republican governors, including Maine Gov. Paul LePage, refused to run their marketplaces, leaving it to the federal government.


As a result, states that will operate their own marketplaces – including Colorado, California and Minnesota – have been flush with television advertising, while states with federally run marketplaces have been left out.

Even though advertising has been weak, many organizations are working to get the word out, and eventually people will know, said Mitchell Stein, policy director with Consumers for Affordable Health Care, an Augusta-based advocacy group.

“The federal market will open. There will be some glitches, but people don’t have to sign up on Tuesday,” the start of the enrollment period, Stein said.

A few signs were up Monday inside the Portland Community Health Center. Outreach specialist Libby Cummings said the staff and more than 30 volunteers are ready to help people sign up for insurance.

Cummings, who is not related to Alyson Cummings, said a table with balloons and signs would be set up outside the health center Tuesday to let people know that they can start enrolling.

Leslie Brancato, CEO of the center, said signage was an important and overlooked point, after a reporter asked about the lack of signs. In response, the health center’s staff ordered signs Monday, to be put on the building permanently once they arrive.

“I think there’s still a lot of people who don’t know, and so we’re going to get those signs put up outside so that people can see them,” Brancato said.

People who are interested in signing up for health insurance in the marketplace can also do so by going to or by calling (800) 318-2596.

Joe Lawlor can be contacted at 791-6376 or:jlawlor@pressherald.comjlawlor@pressherald.comTwitter: @joelawlorph@joelawlorph

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