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Jeffrey Young
Huffington Post

In Washington, D.C., (population 632,000), the drive to enroll the uninsured into health coverage under President Barack Obama’s health care reform law is backed by the city government, federal funding and more than 200 local workers helping people apply for benefits.

In Prince William County, Va., (population 430,000), 30 miles south of the U.S. Capitol, there’s pretty much just Frank Principi.

Principi is the executive director of the Greater Prince William Community Health Center in Woodbridge, a nonprofit clinic. The center is home to 14 doctors, nurses and dentists who care for 10,000 low- and middle-income patients a year, and it charges uninsured people on a sliding scale based on income. It’s also the only place in the county where those who want to use the health insurance exchanges created by the Affordable Care Act can go for certified, in-person help with their applications.

“People are sick, and people are sick of having to pay large amounts of cash, or forgo paying a bill at all and going into bankruptcy,” Principi, 52, said during an interview at the clinic on Wednesday. Principi estimates that about 100 people asked for information on Oct. 1 alone, the day the exchanges opened. Incoming phone calls are up more than 10 percent, he said.

The Obama administration aims to sign up 7 million people for private insurance via the exchanges. This enormous task, challenging under ideal circumstances, is made more difficult by the decisions of many states — mostly Republican-led and including nearly the entire South — to resist the law’s implementation. As a result, the reach of Obamacare’s enrollment drive is expected to vary widely. Fewer uninsured people are expected to get coverage in places like Virginia, which is doing next to nothing to help its residents sign up, than in places like the District of Columbia, which embraced the law’s goals. And that’s not even factoring in the faulty federal website impeding the project in more than 30 states.

There are about 44,000 uninsured people living in Prince William County, according to Centers for Medicare and Medicaid Services data compiled by Enroll America, a Washington-based organization promoting health insurance coverage. Open enrollment on the exchanges, also called marketplaces, runs until March 31. Principi hopes to sign up 2,500 people by then.

Back in the District of Columbia, more than 1,000 individuals or families applied for coverage on the city’s health insurance exchange, DC Health Link, during the first week. The exchange already shifted from the educational phase to the enrollment phase due to intense demand, said Mila Kofman, the executive director of the D.C. Health Benefit Exchange Authority, which oversees DC Health Link.

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