Farmworker Santos V. gets help reading a letter about his ACA insurance coverage from Ana Beltran, an N.C. Farmworkers’ Project farmworker educator. (Photo by Brenda Porter-Rockwell, North Carolina Health News)

This article was produced by North Carolina Health News and is used by permission.

Santos V. sat at a long folding table asking questions in Spanish about a letter he got concerning his health insurance coverage through the Affordable Care Act. For the 52-year-old farmworker, maintaining coverage is a must.

“It’s indispensable,” said Santos, who asked that his last name not be used. Through a Spanish language interpreter, Mackenzie Mann, he continued, “As a farmworker, we are exposed to everything. For this reason, it’s important for us to have health insurance.”

A native of Mexico but living now in central North Carolina’s Harnett County, Santos has been working seasonally in that state for the past 12 years, picking tobacco, sweet potatoes, cucumbers, and other fruits and vegetables. He was on hand for an Affordable Care Act enrollment event at the Episcopal Farmworker Ministry in Dunn on Sunday. (Dunn is a city of about 9,000 residents on the eastern edge of Harnett County, near I-85.)

The event was sponsored by the North Carolina Farmworkers’ Project in Benson, Legal Aid of North Carolina, Stedman-Wade Health Services Inc., Access East, Goshen Medical Center, Greene County Health Care, Lincoln Community Health Center, MDC Inc., and Legal Services of Southern Piedmont.

“We as an organization want every farmworker to have access to affordable health care. The Affordable Care Act increases that access,” explained Mann, an educator with the Farmworkers’ Project. Her organization’s objective is to connect workers to that care.

The May 22 event offered education to migrant farmworkers about the health insurance marketplace. Assisters were on hand to help workers choose a plan and enroll. Others who, like Santos, are already covered, could get help in understanding the paperwork they received post-enrollment.

Qualifying Events

The 50 or so farmworkers who signed up for help missed this year’s ACA open enrollment period. But they’re offered a second chance. A special open-enrollment period allows consumers who experience certain life events – a change in marital or immigration status, for example – to apply after the main enrollment period has ended.

Entering the country on an H-2A work visa is considered a qualifying life event, making migrant workers eligible for the special-enrollment period. The H-2A visa allows non-immigrant workers to work seasonally in agriculture.

After proving their immigration status, the workers must have proof of having paid federal income taxes and have an entry-exit card to prove they’re here legally. They may qualify if their employer offers no health coverage or the employer coverage does not meet the minimum standards set by the ACA.

‘Just in Case’ Coverage

The event was the second for the Farmworkers’ Project. The first was in February 2015, a time of year when large numbers of workers arrive for the planting season. The project covers portions of southern Wake County and most of Harnett, Johnston, Duplin, and Cumberland counties.

Mann said the group must work quickly to get the word out about the Affordable Care Act. Qualifying workers only have 60 days after their arrival in the U.S. to sign up. Rather than guide someone through telephone prompts or point them to the main website in Spanish, Mann said having in-person assisters who speak the language is a better approach. For many, she said, this is their first time accessing affordable coverage, and they need more explanation.

Santos V. said he hasn’t had to use his insurance yet, but that he feels more secure knowing that in case something happens, he’s covered.

Mann said she’s heard stories of workers who were lucky they had insurance. Last year, one worker she’d met broke his leg. After numerous doctor’s appointments, a surgery and rehab, the worker’s treatment cost $32,000. The health insurance marketplace paid $31,000, Mann said.

Another farmworker, she said, had successful hernia surgery as soon as he needed it, rather than waiting to go back to Mexico at the end of the season.

“At the end of the day, workers can continue working and providing for their families” thanks to health insurance coverage, Mann said.

The project had 50 confirmed participants with more who could not get an appointment, Mann said. She hopes to schedule another event in June, when the next big wave of workers arrives for the picking season.

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