The Hartford Courant Dan Haar column [The Hartford Courant]

Oct. 30--NEW BRITAIN -- For nearly three hours after the opening Tuesday of what is believed to be the nation's first Obamacare store, Ernestine Shabazz watched carefully as would-be health exchange customers filtered in and out. That was her job, as the hired security guard.

Then, in a quiet moment on the first day of the store's operation, she asked outreach worker Luke Bajana a few questions. Can people pay for the plans through payroll deductions? Does each plan have more than one provider?

"I, too, need insurance," Shabazz said.

She's employed, and her husband, a veteran, has insurance. But as one of the 350,000 Connecticut residents who don't have coverage, Shabazz is exactly who Access Health CT, the agency running the state's health exchange, is trying to reach.

And the fact that Shabazz emerged into the system from her post as the security guard at the Access Health CT storefront proves the point about why the downtown corner location, next to an Edible Arrangements franchise, just might make sense. If you hope to sign up 100,000 people in three months and you have a $15 million marketing budget to find them, you have to cast a wide net using every means available.

The fight over Obamacare is the spat that launched a government shutdown and has the nation in a policy gridlock. Are the subsidies to prod people to enroll worth the estimated $1.1 trillion cost over the next 10 years? Can federal bureaucrats manage a massive, nationwide system that ties tens of millions of customers to insurance companies, health providers and the government?

Those questions still matter hugely, but to Stasia Rodriguez, the second person to enter the Access Health CT store on Tuesday, what really matters is this: "I can get insurance, that's the best thing."

Rodriguez hasn't had coverage since she lost a job in 1999 and went to work with her husband, who runs a courier business. Sure, she tried, but way back in the past, she started taking medication for high blood pressure -- leaving her forever in the high-risk pool, far too expensive on the cobbled together salaries of a tiny family business.

"Little I knew," said Rodriguez, a U.S. citizen who emigrated from Poland in 1980 and has two grown children.

Once, she said, she and her husband had to pay $5,000 for a hospital stay of less than a full day for their daughter.

And so on Tuesday, she was in the office not long after the noon opening, looking into plans that are offered without regard for prior medical conditions -- the whole point of Obamacare, for her.

"I'm surprised a country that rich and industrialized doesn't have health insurance for all," Rodriguez said.

She's not alone, but how to get there is the problem. Here's an illustration of how tough it is: Rodriguez suggested that Access Health CT open a separate store a few blocks away on Broad Street, where many Polish people live.

If she only knew how hard it was just to open these doors. Back in early June, Access Health CT announced that it would open seven urban stores throughout the state as a way to reach people and offer a physical beacon for a product, and a service, that's abstract, lives online, and is hard for even insurance and health professionals to understand. It was inspired by Apple stores, complete with geniuses on hand.

Then reality hit, and the goal became just two stores -- a New Haven location is set to open next month.

"It was more work than we thought it was going to be," said Kathleen Tallarita, government affairs manager at Access Health CT. "It took us a long time to get the first one open."

At least the opening was glitch-free, unlike the nationwide system that runs most of the state health exchanges. (Connecticut, one of 17 states with its own exchange, has not suffered the national problems other than when the whole system collapsed for a few hours Sunday and again on Tuesday evening.) The store, about 2,000 square feet, is bright, with a crisp, new ceiling and a decor in the Access Health CT colors of orange, red and yellow, with large posters of healthy-looking parents with children who could be in one of those pharmaceutical ads.

The stores are part of a network that includes 300 trained, certified "assisters," and six nonprofit groups working as "navigators," along with, critically, 14 federally qualified health centers with locations throughout the state that will have 100 certified application counselors able to enroll people in the plans. And on top of all that, private insurance brokers who carry all of the plans offered through the exchange are out there working to sign people up -- including some who will populate the two Access Health CT stores.

Residents can sign up online without any of this assistance, but, said Mike Dunn, one of the store managers, "There are some people who prefer to go face to face."

If Access Health CT were a for-profit business, Tuesday might not have looked like a great opening day. Curious and interested people came in to ask questions, pick up some forms, look at the options online. Few actually enrolled, but then again, that wasn't the sole goal on this "soft opening" day. Sign-ups have been slow in the early weeks throughout the country, perhaps because people don't have to make decisions until the end of March, perhaps because of the well-publicized computer glitches, or, as critics believe, because the system isn't what it's cracked up to be.

That third reason seems unlikely, considering that the subsidies make for a great deal for working people at or below the median income level who don't have insurance. Through Oct. 15, a very small time sample, the Connecticut exchange had enrolled 3,847 people through 2,372 accounts, including more than half in Medicaid. The goal is to get two-thirds of new enrollees into private plans.

The reason for the urgency could be found in two places not far from the Main Street, New Britain store: The emergency room of the Hospital of Central Connecticut up Walnut Hill, and the Community Health Center of New Britain, across Route 72. Thousands of people a year arrive at both places, many without insurance, unable to take control of their own health care, often waiting to get medical attention until their health has deteriorated.

"There is enormous pent-up demand," said Evelyn Barnum, CEO of the Community Health Center Association of Connecticut, which represents most of the centers. "We can't keep going on the trajectory we've been going."

Barnum's group was disappointed that it took more than two weeks after the Oct. 1 enrollment date for Access Health CT to certify the health center counselors, even after they had met requirements. These, after all, are the people who see uninsured residents every day and expect to enroll more than 18,000 people. And, Barnum said, Access Health CT is not treating the health centers as a regular part of the effort.

Executives at Access Health CT said that they very much value the work of the health centers. The friction is just one of a thousand pressure points in the vast new universe that is Obamacare.

All of it is background noise for Sophia Toro, a pizza shop employee who is on Medicaid, who came into the store Tuesday with her fiancee, uninsured Alphonso Harrison, who has two part-time jobs. They need to sort out their health coverage, and this was the place to do it.

Complicated? Too many forms? Toro was undaunted. "Life's complicated," she said, smiling at the opportunity in front of her.

An event at The Bushnell on Wednesday night, "What Does Obamacare Mean for Real People?" will explore how the system is and is not working. The 3rd Annual Town Hall Meeting on Health Disparities, sponsored by the Curtis D. Robinson Men's Health Institute, is free and open to the public, starting at 7 p.m. Panelists will include Kevin J. Counihan, CEO of Access Health CT, and Frances G. Padilla, president of the Universal Health Care Foundation of Connecticut. Dan Haar of The Courant will moderate with Al Terzi of FOX CT.

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