Public libraries taxed by demands of Affordable Care Act

While government officials in Washington work to repair the Affordable Care Act's enrollment website and Congress investigates the site's breakdown, Maryland resident Marie Williams goes to her local library every week to take computer classes. Like many Americans, Williams does not have email or know how to use a keyboard; a few of her classmates have never used a computer mouse before the class. And yet, nationwide, patrons just like her are required to understand the new health care website, even as they lack basic computer skills, email addresses and access to the Internet.

American public libraries — those robust institutions tasked with ensuring free and open access to the world’s knowledge — have always been resources for information. As thriving community centers, libraries are trusted places that Americans look to when they need children's books, job training, homework help, Internet access, historical information or research assistance. For years, they have also been places that people from all walks of life visit when they need government information or help accessing the resources available to them. Librarians help people complete Social Security forms, file court petitions and even pay their taxes online. In 2009, 77 million people, or roughly 34 percent of the entire U.S. population, used a public library computer or wireless network to access the Internet.

Now libraries are facing an increasing number of patrons who need assistance with enrolling in a health insurance plan under the Affordable Care Act. At my own library, the Skokie Public Library of Illinois, requests for information on the health law started building in September. Close to 100 people attended an Affordable Care Act program in October. But as more patrons turn to their local libraries for resources and assistance, those facilities are finding that they have to do more with less: Funding has dwindled even as community demands for library services have soared. Research shows that, for the past three years, more than 40 percent of states have reported decreased public financial support to libraries. Since 2010, federal funding for libraries fell by $38.5 million, even as the American Library Association (ALA) asked Congress to end budget cuts to the Library Services and Technology Act. Meanwhile, demands on libraries increased significantly as people turned to them for resources and job support during the recession. For example, the Appleton Public Library in Wisconsin saw a 52 percent increase in public computer use during the start of the recession in 2008, when many patrons went there to apply for online job postings. However, from 2011 to 2012, 57 percent of libraries reported flat or decreased operating budgets, while 60 percent reported increased use of public Internet computers.

Complicating matters, libraries are charged with helping patrons cross what is often called the "digital divide." A recent study found that 62 percent of libraries report that they are the only source of free Internet access in their communities. In the working world, more than 80 percent of Fortune 500 companies require online job applications, and about 60 percent of working Americans need the Internet to do their jobs. Many of our patrons rely completely on public libraries to find job opportunities and learn skills needed to compete in the global economy. On top of all of this, library Internet speeds are already overtaxed: the average public library has the same connectivity as the average home Internet, even though multiple patrons are using library connections at the same time. The ALA and other groups are calling on the Federal Communications Commission to reform the federal E-rate program, which funds Internet connections in libraries.

In the past decade, 28 million people in the U.S. have gone to libraries to seek assistance with health and wellness issues, including medical conditions, nutrition and health care provider listings. As such, even before the Affordable Care Act website went live on Oct. 1, libraries expected to receive a number of new questions on how to use the health insurance marketplace website. Librarians were concerned, however, about the enrollment process, because the new health law application, like many new tools and services produced by the government, is available only online, inconveniencing Americans who lack computer access. Since October, patrons have turned to their local libraries for computers, Wi-Fi access and high-speed Internet information about the law and filing process. As a result, those facilities have had to tap into their limited funds in order to offer resources and informational sessions on the health law.

With an uninsured population of nearly 72,000, the Waukegan Public Library of Illinois is hosting informational sessions in collaboration with local organizations to provide patrons in one of the area's largest cities with the information they need. While the Institute of Museum and Library Services and the Centers for Medicare & Medicaid Services have provided training resources to libraries on the Affordable Care Act, libraries have not received additional funds to address the increasing demand for health-care-related information.

"I understand the value that libraries can contribute to (the health law) process and look forward to being able to offer this assistance to my community," wrote one Kansas librarian, who asked not to be named, in a letter to the ALA expressing why she thinks government should provide more funding for public libraries during the health insurance open-enrollment period. "However, there will be considerable expense in staff training and staff hours of assistance to the public."

Libraries are becoming increasingly valuable in the digital age. While they will continue to provide our communities with the guidance and information they demand, libraries need additional funding to continue these vital services in communities across the nation. As more services, tools and job applications move online, we must ensure that our libraries provide the professional assistance and resources that our communities need.