Mohamed Obsieh didn’t believe the Affordable Care Act was really working until he heard his immigrant friends had enrolled in the new health insurance marketplace.

So Obsieh, 64, of Djibouti, a country in the Horn of Africa, showed up at the Maine Access Immigrant Network in downtown Portland on Tuesday to inquire about signing up for coverage as well. He was assisted by a translator.

As an immigrant seeking asylum, Obsieh belongs to a hard-to-reach population that health advocates are trying to sign up as part of a last-minute scramble to enroll patients before the March 31 deadline. Those who don’t sign up by then face a potential penalty.

Health care officials descended on Portland on Tuesday for a number of enrollment events and to talk up the benefits of the Affordable Care Act.

Also on Tuesday, the U.S. Department of Health and Human Services released nationwide and state-by-state numbers that showed enrollment increased by more than 27 percent nationally in February when the total reached 4.2 million. In Maine the number signing up for coverage through the marketplace increased from 20,511 in January to 25,412 by the end of last month.

Maine has been signing up people at a faster clip than the national average, although in February Maine’s 24 percent increase trailed the surge nationally.


While enrollment efforts are urging everyone who qualifies to sign up, advocates are targeting populations that may not be hearing messages through traditional means. That includes Portland’s population of African immigrants who arrive here as political refugees.

Obsieh, a refugee seeking asylum, has his green card and is working as a custodian, earning close to the income level that would make him eligible for generous subsidies in the health insurance marketplace. Those who earn between 100 percent and 400 percent of the federal poverty level are eligible for the subsidies.

Obsieh remained unsure about signing up, but said he’d like being able to see a doctor if he can afford coverage.

People who are here legally, including immigrants and refugees with work permits, can sign up for health care coverage in the marketplace. However, refugees who don’t yet have permission to work in the U.S. can’t sign up for health insurance until they’re cleared to work here, officials said.

Sarah Lewis, program coordinator for the Maine Access Immigrant Network, which changed its name from the Somali Culture and Development Association to better reflect its mission to help all immigrants, said since the group began working in January to help immigrants obtain health care, about 60 have looked into purchasing insurance on the exchange.

Lewis said the personal touch – more than advertising – is what matters for immigrants.


“Talking to someone who speaks their language who went through similar experiences that they did is massively breaking down the barriers (to enrollment),” Lewis said.

April Gilmore of the Maine Lobstermen’s Association is helping workers in that industry obtain coverage, and she says it’s going well.

Working in the seasonal seafood industry requires long hours on the water, Gilmore said, so she makes sure to meet crew members in the evening or in the off-season to spur enrollment.

She said despite all the hype and negative coverage over the rollout of the Affordable Care Act, most lobstermen have practical questions about it.

“Most people are really grateful to have the opportunity for health care,” Gilmore said. “They want to know whether they can afford it.”

Many in the seafood industry are self-employed and have gone without insurance until now.


At Maine Medical Center in Portland, a group of health officials on Tuesday urged people to sign up for coverage before the March 31 deadline.

Wendy Wolf, executive director of the Maine Health Access Foundation, said they are looking at ways to goose enrollment, including appealing to young adults, who have lagged in their sign-ups. The foundation has spent more than $2.5 million over the past year in various efforts to increase sign-ups.

A print ad shows a “naked”young man with a computer covering his torso, with a headline that says, “Dude, it’s time to get covered.”

“We had to grab their attention somehow,” Wolf said.

Christie Hager, New England regional director for the U.S. Department of Health and Human Services, said Maine is one of the nation’s leaders in getting people enrolled, and at the end of January had the most success among the 35 states using the federally run marketplace. Maine used a grass-roots network that included hundreds of paid and volunteer workers helping to sign people up.

Hager said the time-honored, door-to-door approach is working in Maine.


“It’s pretty exciting to see the work being done here in Maine,” Hager said. “Maine is a leader, and everyone else should find out how they did it.”

Carolee Pojak of Falmouth started looking into enrolling for health care coverage on Tuesday at Maine Med after being without coverage for several years. A self-employed graphic artist, Pojak said she was just starting to figure out whether she could afford the benefits, but she believed she would be able to. Pojak was being assisted by Fran Gleason with the paperwork.

“It would be a huge relief to have coverage again,” Pojak said.

Joe Lawlor can be contacted at 791-6376 or at:

Twitter: @joelawlorph

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