The Friday afternoon call to prayer echoed through the cavernous Somali Mall 24, sending scores of men, and a few women, up the stairs to worship.
Others shopped for clothes or jewelry, and a warren of small, dark cafes was filled with men drinking super sweet Somali tea and watching international news on flat-screen televisions.
Lucky Ahmed stood at a small table a few feet away from piles of colorful carpets, selling something else that drew the curious.
Ahmed was handing out brochures and answering questions about MNsure, the state’s health care marketplace answer to the Affordable Care Act.
Sometimes, she directed them to a nearby cafe, where two “navigators” were helping people sign up for care, sometimes for the first time since they’ve been in the United States.
The navigators work for Somali Health Solutions, one of many outreach organizations contracted to educate potential MNsure customers who are hard to reach.
“We go to where the people are, where they are comfortable,” said Asli Ashkir, a registered nurse and CEO of the organization. “We speak their language and here [the mall], it feels like home.”
The Somali community is like many others, where knowledge of the new health care law varies widely.
“Some already have insurance [through jobs] and don’t worry,” Ashkir said. Few people express opinions on the new health care law or the politics. “People are more concerned about how much it will cost.”
One young man asked in Somali, “Why now? Why do they care about us now?”
With the disastrous rollout of the ACA, the political turmoil and legitimate criticisms about broken promises, the man asked a good question.
The short answer is that the old system didn’t work, and it left out millions in the richest country on earth. I have no clue whether health care changes will eventually be embraced, as they have in other countries, or whether the new system will implode through its own inertia.
But Ashkir, with 30 years of experience in both education and clinical settings, knows it had to change.
She’s seen her people coming into emergency rooms for checkups, people avoiding doctor visits when they are sick and patients without insurance racking up huge debts they cannot pay. The young tend to think they are invincible and won’t get sick. “They say if they have to go to the doctor, they would rather pay out of pocket,” Ashkir said.
She explains that a young person who pays, say, $100 per month, would be covered in the event of a trip to the emergency room that could cost a lot more.
“If you fall down and break your leg, it might be $3,000,” she tells them.
“I say, it’s going to be your responsibility now,” said Ashkir. “Your grandmother gets a lot of care, and you have to help pay for that.”
That is a pretty basic tenet of any kind of insurance that people who complain they may never use, for example, mental health services. No one buys insurance, whether it’s auto or health care, hoping they have to use it enough to cover their payments. They buy it hoping they never have to use it.
Ashkir said people have been signing up at the mall. Some go smoothly — “maybe 20 minutes for a single person.” Others take longer.
“If we are able to help them get insurance, they are so happy,” said Ashkir. “They say, thank you, thank you, thank you.”