BISMARCK, N.D. (AP) — An advocacy group intends to help spread the word to homeless people in North Dakota about insurance marketplaces created by the Affordable Care Act.

Enrollment for the online marketplaces opens Tuesday under the federal health care act championed by President Barack Obama. But educating the soaring number of homeless people flocking to oil-rich North Dakota about the new health care law is a colossal challenge for so-called navigators, whose job is to find uninsured residents and inform them of their options under the new law, said Michael Carbone, executive director of the North Dakota Coalition for Homeless People.

Homeless people in North Dakota may be overlooked despite well-intentioned outreach efforts funded by the federal government, Carbone said.

“I don’t think these navigators will be looking under bridges or along railroad tracks,” he said. “It’s not going to happen if we rely on navigators alone. It’s going to take cooperation from all agencies in the state to make this work.”

North Dakota is among 36 states where the federal government will run the marketplace under the new federal law that requires most people to have insurance starting Jan. 1 or face penalties. Starting Tuesday, uninsured North Dakotans can compare and buy health insurance plans through the federal marketplace.

About $1 million in federal money is being spent on health care outreach in North Dakota, where an estimated 74,700 people are uninsured. Along with advertising, mailings and other outreach efforts, the federal money will fund about a dozen navigators, who also can advise people on whether they’d be eligible for Medicaid, a joint state-federal health care program for the disabled and poor.

Carbone said it’s likely that most homeless people in North Dakota would be eligible for Medicaid under the new law.

The number of homeless people in North Dakota has risen to a record level despite a robust economy fueled by the oil boom in the western part of the state. Volunteers counted more than 2,000 homeless people during a one-day survey in July, Carbone said.

Homeless people have been found living in cars, tents, under bridges, grain bins, haystacks and culverts, Carbone said.

As part of the survey, people were asked if they had health insurance and “100 percent said no,” Carbone said.

The group is crafting a plan to reach the homeless but is relying heavily on word-of-mouth, which tends to be the most effective communication method, Carbone said.

“A lot of these people already have social networks, even people who are pretty reclusive,” Carbone said. “Word-of-mouth on the streets works. It’s just a matter of getting a few people started and working from there.”

North Dakota’s navigator program is being headed by Neil Scharpe, a research coordinator with North Dakota Center for Persons with Disabilities in Minot. Navigators will do everything from knocking on doors to visiting libraries, businesses and health clinic waiting rooms. They also will rely on other agencies and groups to inform people about the new health care law.

“Awareness is a big issue,” Scharpe said. “Are we going to find that guy in a haystack? Maybe, maybe not. Finding that guy is going to depend if somebody knows he’s there.”

(© Copyright 2013 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)


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