Daily Archives: September 12, 2013

Affordable Care Act – Librarians’ Dilemma


On August 1 I posted Some Libraries Resist Assisting ObamaCare – Some Librarians Express Concerns and echoed some librarians concerns about essentially “promoting” ObamaCare to library users. Recently, I participated in a teleconference call hosted by HHS addressing issues and questions about implementation of the Affordable Care Act.

This third in a series of three calls is intended specifically for stakeholders in Utah where there will be a Federally Facilitated Marketplace for the individual market and a State Based Marketplace for the Small Business Health Options Program (SHOP). The call will feature HHS and CMS Denver Regional Office officials and an Avenue H official followed by time for Q&A. Speakers are:
• Doyle Forrestal, Acting Regional Director, U.S. Department of Health and Human Services
• Jeff Hinson, Regional Administrator, Centers for Medicare & Medicaid Services (CMS)
• Patty Conner, Executive Director, Avenue H
Questions about the event? Contact ROReaORA@cms.hhs.gov

The first 30 minutes was a “canned” presentation literally read from scripts (you can always tell) about a lot of government acronyms that describe the many layers of bureaucracy that will bring this program to the public, while protecting your private medical information, containing lots of declarations of privacy protection, safeguards against fraud, etc., as well as a progress report on Centers for Medicare & Medicaid Services (CMS) Region 8 being ready for the October 1 deadline to go live. Once a listener gets over the $68 Million in federal grants to 51 community-based organizations in 11 states to train an unknown number of “navigators” to help people apply for healthcare, some of what was outlined seemed good – especially the requirement for Certified Application Counselors to be certified through training, be bonded like company treasurers and accountants, and licensed by a state’s department of insurance. It all generally sounded like a good thing, assuming that one can believe everything they are told by the government. [NOTE: Training for Navigators, Certified Application Counselors, and Agents and Brokers will be web-based.]

During the second 30 minutes devoted to Q&A, I was able to ask a question. In a few words I asked what they saw as the role of librarians in “promoting” this federal program. Of course I prefaced my question by assuming they all knew about the President’s video presentation at ALA, other agencies promotion of libraries becoming partners in advocating the program, etc. The answer I got, in a nutshell, mostly from Ms. Forrestal, was that libraries and librarians were not expected to be “navigators” or counselors to help people fill out online applications for healthcare, but, as I suggested, they simple provide access to information like they have always done with federal income tax forms. OK, after that I was fairly satisfied.

However, the caller immediately after me was a guy who was at that moment conducting training for a county library system in my state. He thanked me for the segue and told listeners that the librarians he was training were very enthused and interested in becoming Certified Application Counselors – the people who have to be trained, bonded and certified. My reaction was not one I care to share publicly.

My reaction to librarians who embrace this “service” on such a personal level is that they must be wearing blinders to forget what libraries and librarians have been doing for the past 3-4 years – HELPING MILLIONS OF LIBRARY USERS FIND JOBS.

Remember the economic downturn that put so many people and companies out of business that unemployment became the number one issue in America? Remember the gut-wrenching library closings of 2009, 10 and 11 because the local economy was so bad? Remember the ALA and PLA and every library organization extoling the value of the local library BECAUSE IT WAS THE MOST VITAL RESOURCE HELPING PEOPLE FIND JOBS?

Are you not listening to the impact that the Affordable Care Act is and will have on businesses and jobs? Are you not aware that labor unions are no longer supporting the Act? Are you not aware that normal healthcare insurance costs are already rising? Are you not aware that Congress is debating not funding the program because it does more harm than good to the economy? Are you not aware that employers are cutting employee hours even further to get below the 29 hour level so they don’t have to provide healthcare benefits that will bankrupt their business? Are those of you who are currently working less than 40 hours a week in your library prepared to work less than 30 hours a week because your school district, city, county, state, or university can’t afford the outrageous cost of healthcare?

Do librarians not understand the dilemma they are now being forced into? First we “do more with less” and help millions of our neighbors try to find employment. AWESOME!

Now we’re being asked to become “Champions for Coverage” (yes, I had not yet mentioned that advertising hooraaraa incentive for libraries) and to again be good public servants – regardless of the impact. Before librarians jump on this latest “public good” bandwagon, I strongly encourage them to research the impact of this program, rather than simply keep the blinders on and follow the parade down the new path toward more joblessness.

Remember that the “service” to jobless library users was not a government program. It was something that libraries understood was in the best interest of all concerned. Libraries were not asked to endorse or promote a government “program.” Being asked to endorse the Affordable Care Act is not in the best interest of libraries, or librarians. We are not government pawns to be sacrificed for some greater good – especially when there is no clearly identifiable “good” in it. I still agree with commentor StephenK who commented on LISNews blog, “Alas I don’t see this ending well.”

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