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Washington’s new health insurance exchange dispatched a sign-up envoy to one of the city’s gay clubs one recent night to get out the word about Obamacare. It envisioned men mingling on the dance floor, a cocktail in one hand and enrollment information in the other.
But the brochures about DC Health Link, as the exchange is called, weren’t snapped up as quickly as the free condoms provided by a local clinic.
Like other health exchanges and coverage advocacy groups across the country, DC Health Link is reaching out to people wherever they may be, including bars. President Barack Obama even urged bartenders — who may themselves be uninsured — to hold happy hours to talk about health insurance and what it can offer young adults.
That strategy has clear challenges, however. In a packed nightclub like Town Danceboutique in Northwest D.C., music smothers conversation, dimmed lights make reading difficult, and health coverage is not what’s on people’s minds.
“They’re looking to let loose. They’re not looking to talk about serious topics,” patron Maven Saleh said as he surveyed the Town crowd on a winter weekend.
Add an appearance by Santa wearing a “Naughty” hat as he posed for pictures on stage, and DC Health Link assister John Esposito had a near-impossible task that night. Positioned behind the stage and bar area, he stood by a small table offering not just information about insurance enrollment but packages of condoms and tubes of lubricant. The latter items were courtesy of the Whitman-Walker Clinic, which also had its HIV testing van parked outside.
“It’s not about drawing a huge drove of people to the system,” explained an upbeat Esposito, who by day is stationed at Whitman-Walker as part of the DC exchange’s ongoing work with the lesbian, gay, bisexual and transgender community.
After getting off to a disastrous start Oct. 1, the enrollment push is intensifying as the first hard Obamacare sign-up deadline nears. Individuals who want health coverage starting Jan. 1 must pick a plan by Monday and pay their first premium before the ball drops on New Year’s Eve. So in Washington and cities across the country, advocates are trying to cover traditional bases like colleges, worship places and grocery stores plus some less typical places — like under the sparkling disco ball at Town Danceboutique.
Several weeks ago, hundreds of people showed up at the downtown D.C. library for an enrollment fair featuring a children’s moon bounce and an adult Zumba class. This past weekend, local assisters were posted at two shoe stores to catch young people out shopping because of the long-awaited relaunch of Air Jordan Taxi sneakers. Other sign-up workers stayed up late to greet diners chowing down on bacon and eggs at a Denny’s after a rowdy night out. The goal is to drive sign-ups well past the 5,063 individuals and families that had applied for coverage as of Dec. 10, the latest DC figures made public.
Tailoring outreach to targeted populations makes sense, of course, and nightclubs are a logical location for Washington’s LGBT community. Gays and lesbians represent a significant percentage of the 42,000 people who are uninsured in the District. Most are African-American and live in four wards where the uninsurance rate averages about 18 percent, far higher than the rest of the city.
The White House has stressed that gays and lesbians are more likely than other groups to be uninsured nationwide. The administration has been working with LGBT groups and on Tuesday released an infographic on ways the Affordable Care Act benefits them, including coverage for same-sex spouses and coverage of preexisting conditions including HIV/AIDS.
“A gay club is like the best way if you’re trying to reach that community,” said Kabuki Lee, one of Santa’s helpers at the Town club the other night. “This is where they come to feel comfortable.”
DC Health Link’s first such effort was in October when it swung by ladies night at Cobalt, another popular venue. The evening was instructive. Patrons, bartenders and bouncers were open to talking about health insurance, but all were a bit startled when the subject was brought up. The assisters realized they needed to soften their approach to more effectively engage people.
No more direct questions like, “Do you have health insurance?” Instead, they now ask, “Do you know anyone who is uninsured?”
Esposito put those lessons into practice at Town Danceboutique, only talking to people if they came up him at his table. Early on, there weren’t many.
As the hour got later and people loosened up, however, the traffic started to increase. More than a dozen guys who’d stopped by to grab condoms also took one of the Health Link’s info cards, chatting briefly with Esposito about the new insurance options created through Obamacare. Still, no one filled out the follow-up worksheet that would have enabled him to walk the person through the steps to actually signing up.
Timing might have been part of the problem. Most of the men who attend the club’s 6 to 10 p.m. happy hour are older, highly educated and likely have employer-provided health coverage, regulars said. A younger crowd, perhaps with higher rates of uninsurance, shows up later.
“We’re still sort of learning the ins and outs of this,” said Chip Lewis, deputy director of communications for Whitman-Walker.
Esposito wasn’t discouraged despite speaking to such a small number of people. DC’s uninsured have fallen into the cracks, and finding them is like “trying to hit a moving target,” he said. Even if all the people he talked with already have health coverage, they might have a friend or a family member who doesn’t, he said. Now they’ll know how to get help.
Despite the minimal results to date, the exchange plans to keep hitting the club scene to interest potential enrollees. Esposito says he’ll come back to Town, although likely arriving later to maximize his sign-up prospects.
A bit before 10 p.m., he began gathering his information cards and blank follow-up sheets to head home. But the club was just beginning to pulse.
Dancers in sequined, skintight costumes strutted their stuff in a cabaret-style drag show. The floor reverberated from the sound system’s amped-up bass. The disco ball turned and sparkled. And an enthusiastic audience whooped and waved, offering handfuls of dollar bills to the performers.
Off to one side, having already moved their condoms-and-lubricant table downstairs, the volunteers from the HIV testing van danced along.