Champions of Change Blog

Serious Illness Taught Me the Value of Insurance

Cecelia Smaha is being honored as an Affordable Care Act Champion of Change.

I don’t remember driving home from work with the Georgia Department of Labor on November 19, 1999. I had flu-like symptoms and felt awful that day. My housemate was so alarmed when I arrived home that she tried to get me to call an ambulance. I refused because my insurance would not pay for the ambulance if the hospital didn’t admit me. I didn’t think I was that sick, and I couldn’t afford to pay the ambulance fee.

Blessed by God to have such a caring housemate, I made it through the weekend. But on Monday, I ended up in the hospital in a coma and was placed in the acute intensive care unit. Three weeks later, I awoke from the coma to learn that I’d had a severe E. coli bacterial infection and was lucky to be alive.

I was in the hospital for seven weeks, but I also had a long period of recuperation to follow that hospital stay. I never gave any thought to the cost of my hospital stay until I got the bill from the hospital. I couldn’t fathom paying almost a quarter of a million dollars! And that bill didn’t even include any of the doctors’ bills nor the aftercare with home nurses. I didn’t have that kind of money. The only thing I owned was my car.

I was advised not to pay anything until I checked with my insurance company. As it turned out, my insurance paid for everything. Because of residual effects from this illness, I still have medical complications, but my insurance continues to pay. This was a lesson of a lifetime: Everyone needs insurance.

On December 12, 2001, I was privileged to become an associate of the Institute of the Sisters of Mercy of the Americas South Central Community. In this role, I help provide services to people who are less fortunate, including the economically poor and the less well-educated. When the Affordable Care Act passed, I was jubilant. I saw this as an opportunity to put Mercy into action. I jumped at the chance to help spread information about the ACA through Get Covered America in Georgia.

I gave my time and energy to helping get the word out at churches, on the streets, and by working 10 hours each week for more than two and a half months at our local Kmart. Through a mutual agreement with Kmart and Get Covered America, I was privileged to do an event at our local Kmart, where I set up a table and greeted customers, explaining the Affordable Care Act to local shoppers. Through these opportunities, I helped make contact with over 2,000 Georgians.

I look forward to working with Get Covered America again this year. I am also spreading the word about my state’s refusal to expand Medicare, and I’m working to ensure its expansion—because nobody should be left without health insurance.

Cecelia Smaha is an associate of the Institute of the Sisters of Mercy of the Americas South Central Community.

Using Partnerships to Reach Into Communities

Mark LeBeau is being honored as an Affordable Care Act Champion of Change.

In California, tribal governments, tribal health programs, and the California Rural Indian Health Board (CRIHB) worked together to develop and share educational materials about the Affordable Care Act prior to its passage. Upon enactment of the ACA, CRIHB partnered with the Northwest Portland Area Indian Health Board, Oklahoma City Area Inter-Tribal Health Board, and United South and Eastern Tribes to develop tribal-specific educational materials about the legal rights of tribes and American Indian and Alaska Natives (AIANs) under the ACA. These partners each contributed funds to help make this work a reality.

This program became known as the Tribal Education and Outreach Consortium (TEOC). The people involved in this work became highly knowledgeable about the subject matter and formed a training program called TEOC University, which trained trainers to present the information to tribal communities. This was the first tribal work of this type in the United States, and the TEOC materials have been distributed throughout Indian Country.

Today, a number of federal and state offices provide these materials. Many of these materials have been reviewed and updated by CRIHB and the other members of TEOC. One of the most well-known programs we’ve helped with has been the National Indian Health Outreach and Education Initiative (NIHOE). This is a partnership between the Indian Health Service (HIS), the National Congress of American Indians, the National Indian Health Board, and representatives from each of the 12 IHS Areas. The partnership develops consumer-oriented materials to assist AIANs in understanding their opportunities under the ACA. Together, the partners provide local trainings, national marketing tools, and e-resources that clearly explain health reform changes and their impact on tribal communities. CRIHB has presented these materials to tribal governments, Indian health programs, and Indian communities and organizations.

To ensure the successful roll-out of the ACA in California, CRIHB policy staff have been meeting with state officials on a regular basis.  In addition, CRIHB has reached out to the Northwest Portland Area Indian Health Board (NPAIHB) for input in developing successful implementation strategies and tactics.

These strategies and tactics were incorporated into a proposal developed by CRIHB, which was presented to the state as a necessary and fundable ACA program. Eventually, the state agreed to fund our program. As a result of this work, the Covered California Tribal Community Mobilization program was created and funded at $250,000. The grant designated funds to support implementation of the ACA AIAN provisions and to meet the tribal consultation requirements outlined in federal guidance. While this grant will end in December of 2014, I and the rest of the folks at CRIHB will continue to seek additional financial resources in order to continue to implement this important work for Indian Country.

Mark LeBeau is Executive Director at the California Rural Indian Health Board.