On the first anniversary of the California Uninsured Help Line in May, Phil Lebherz, founder and initial financier of the free call line looked at national studies and became convinced the uninsured numbers could be cut in half in all states if people knew about the public programs available to them. As a result, he plans to make the help line operable in all 50 states by this fall. This initiative can take the pressure off insurers, he claims, who receive much of the blame for the rising number of uninsured in the United States.INN: What is the California Uninsured Help Line? How does it work?

Lebherz: The California Uninsured Help Line (800-234-1317) is a free call-in center for Californians seeking public health care programs. It is staffed 24 hours a day, seven days a week with live counselors and interpreters who speak multiple languages, and offers basic screening for both public and private low-cost health insurance. Counselors help callers identify their potential options and connect them to the correct agency and program representatives. The call center can also directly refer the caller to the appropriate state-sponsored program according to various medical conditions and then guide the caller to obtain the appropriate health coverage.

INN: Where is the call center located? How many people work there? What kinds of technologies does it use?

Lebherz: It's located in Fresno, Calif. There are approximately one dozen live counselors answering the phones, so there is no telephone-tree technology to confuse or deter the caller. This is important because in order to qualify them for public programs counselors have to ask personal questions, such as how much income they make and their family situation. We use a combination of access databases and telephone answering service software to route, track and record the appropriate information.

INN: What is your past experience in the insurance industry, and what made you want to launch this program?

Lebherz: I have been helping Californians find health coverage since 1977. In 2002, I began researching the number of uninsured in California and discovered a startling fact: Nearly half of those people who were uninsured were eligible for subsidized or low-cost programs but were not enrolled.

Obviously the system was not as broken as the media made it out to be. There was simply no good distribution method to get the word out. As I continued to collect evidence, it was clear that the complex, confusing and sometimes even frightening enrollment process was a key factor in the under-enrollment of available programs.

Committed to simplifying the access process, I provided seed money to create a foundation and embarked on a "Coverage For All" campaign in an effort to reframe the debate concerning the uninsured. We launched the Foundation for Health Coverage Education (FCHE) at the National Health Policy Conference in Washington, D.C., in 2003-and back in California put together a multiple-pronged effort that provided tools to help qualified residents enroll.

INN: What are you doing to nationalize the program? What progress have you made on that front?

Lebherz: The California Health Care Options Matrix (see matrix illustration on next page), the California Uninsured Help Line and the FHCE story of how to access a state's public and low-cost programs have recently gone national, initially covering 14 states this summer and the remaining 50 states some time this fall. Already all 50 states have their own matrixes (available on www.coverageforall.org) and they will be hooked into a national help line later this year.

INN: What were the results of the California initiative?

Lebherz: On the first anniversary of the California Uninsured Help Line operation, it was obvious that the sheer number of calls received clearly point to a single major need. California must do a better job to educate the uninsured about public programs that are "on the books" but underutilized.

Of the nearly 6,371 calls reviewed, the majority were from Californians (5,268) seeking to qualify for public health insurance. Of those seeking eligibility, women outnumbered men nearly two to one-3,590 versus 1,678. A total of 41,000 copies of the English and Spanish matrices, and 46,368 copies of the consumer pamphlet about health insurance have been distributed in response to the calls.

INN: How are insurance carriers responding to this? What's in it for them?

Lebherz: We have had tremendous response from insurance companies in California that have jumped in to help fund the help line and the matrix tools.

In addition to using my own resources, the campaign has been funded by grants from the Foundation for Health Coverage Education, California Association of Health Underwriters, Blue Cross of California Foundation, Health Net, Kaiser Permanente and Sharp Health Plan.

As we begin to move across the nation, we're hoping to see support from insurers on a national level. For insurers, this campaign is a chance to reframe the debate and identify that the system would function better if those in need had adequate access to information about coverage they are actually eligible for. Then, this population could receive preventive care rather than merely having to present themselves to our health care system only at a time of medical emergency.

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