For most people in this country, there is no escaping the complex web of the American health care system. Fabric Health, a Philadelphia-based startup, wants to make it just a little bit easier for lower-income families.
Fabric Health, which expanded to Pittsburgh in April, has an interesting model: It sets up in laundromats and helps patrons waiting for their laundry obtain their insurance, gain benefits or procure affordable medicine. The point is that people have to wait two hours for their laundry anyway. They might as well spend that time breaking through the red tape of the health care system.
“We started this with the thesis that time is the scarcest resource for families,” co-founder Allister Chang said. “We were thinking about how we can expand access to health care by meeting people where they are available.”
Now is a particularly important time for Fabric, which can be found in five Pittsburgh locations (Edgewood, Mount Washington, Shadyside, South Park and West Mifflin). The pandemic-era promise of continuous Medicaid coverage ended a few months ago, meaning states are cutting off people deemed ineligible and forcing everyone else to renew their coverage.
The problem is many people don’t realize that they have to file paperwork to renew their Medicaid. Complicating the issue further is the bureaucratic difficulty of sending renewal notices to the right addresses and phone numbers. KFF, a health policy organization, reported that nearly 4 million Americans have been disenrolled as of Aug. 8.
Many of those people are still eligible but simply haven’t realized that they need to re-enroll — either because they didn’t recognize the letter in the mail or because they never received one in the first place. The Washington Post reported on these nationwide procedural failures in late July.
Western Pennsylvania is no different. In its most recent public data from June, the Pennsylvania Department of Human Services documented that of the 118,000-plus people who were deemed eligible for renewal, 85% had yet to complete that renewal.
“Urgent for us is Medicaid recertification,” Chang said. “It’s the burning fire.”
Letting people know about this new Medicaid development has been a big part of Fabric Health’s work since it expanded to Pittsburgh.
Its focus, Chang says, is becoming a familiar, everyday presence in the community. When he talks about the people helped in the laundromats, he refers to them as “our families.”
“It’s making sure we’re building trust and being there consistently,” he said. “I don’t believe in the pop-up model. So many of our families have been scammed and lied to in the past.”
Fabric Health aims to fill a gap in health care navigation support. It’s difficult for anybody to figure out what benefits they are eligible for and what programs can help them receive necessary support, much less busy working parents. Chang finds that the information overload of the health care system turns people off.
“We undervalue the importance of these navigation services,” he said. “The assumption that ‘if you build it, they will come’ does not account for the messiness of information overload. You need to cut through the noise to get relevant, accurate information.”
Sometimes, the benefits aren’t even health care-related. Chang used the example of the Affordable Connectivity Program, which is a part of President Joe Biden’s Bipartisan Infrastructure Law. The program provides significant discounts on internet service and computers for people who qualify. Chang said that there are some neighborhoods in which only 6% of eligible families have enrolled.
Since expanding to Pittsburgh, Fabric has partnered with UPMC’s For You program, a Medicaid-managed care plan, and that initiative provides provides Wi-Fi access as Fabric Health staff work in those laundromats, according to the UPMC’s For You website.
In the news release announcing the partnership, it pointed out that more than 32 million Americans utilize a laundromat each week, so these businesses provide many opportunities to connect with individuals who may need support, according to Fabric Health.
The partnership primarily helps to vet the advice that Fabric Health gives to people at laundromats — ensuring that they are “getting the right answer,” Chang said.
“There are so many resources that are available to Medicaid-eligible families that are being severely underutilized,” he said.
He told the story of a mother who, in the process of recertifying her Medicaid coverage at a laundromat, mentioned that her kid hadn’t received a checkup at the doctor’s in three or four years. The last time she’d gone had produced an exorbitant bill. Fabric Health partnered with her insurer to find a primary care physician for her child that would be more affordable.
“Those stories concern me,” Chang said.
Fabric Health has plans to expand within Pittsburgh and to additional cities. Its focus for now remains helping people renew their Medicaid coverage and integrating into communities.
“People are receptive if you build and earn trust,” Chang said.
Harrison, a rising senior at Denison University, is a Union Progress summer intern. Email him at hhamm@unionprogress.com.