If you don't already have health insurance, you have less than two weeks to either get covered or pay up.

The deadline to enroll for insurance under the Affordable Care Act is March 31.

By that day, nearly every American is required to have insurance or risk paying a fine of $95 or 1 percent of their income, whichever is higher. Someone who makes $25,000 a year and doesn't get insurance, for example, would have to pay a $250 penalty on next year's taxes.

Last month, more than three-quarters of uninsured people were unaware of the deadline, according to a poll by the Kaiser Family Foundation.

And York faces its own challenges in regard to health care, said Jenny Englerth, CEO of Family First Health.

She described the process of navigating the law from October to now as an "incredible learning curve" that has presented pitfalls and challenges while allowing health care providers to better understand patient concerns.

'Sticker shock': Overall, Englerth said, there are three steps to taking charge of your health care.

First, get insurance in some way. Second, understand the insurance marketplace will be open throughout the year so people who lose their jobs or whose insurance status is affected in other ways can make changes. Lastly, take the opportunity to better understand the coverage you have.

"Dig in and understand what coverage is available to you and become a more engaged and educated consumer," she said.

Family First, which has five locations in York and surrounding areas, has helped about 400 people get covered and assisted nearly 1,000 during the open enrollment period, Englerth said.

And the organization is holding a group enrollment session at its center for individuals who need assistance.

"The biggest concern by far is cost," she said.

Although a majority of the people the center has assisted have found affordable plans, Englerth said, some have felt they couldn't afford coverage.

"There could be a little bit of sticker shock for people," she said, especially if they haven't gone through the insurance-shopping process before.

After this open enrollment period ends March 31, the next is set to begin Nov. 15. Between those dates, the marketplace will only be available to those who experience events that change their insurance status.

Looking forward: Many states have chosen to expand their Medicaid programs, allowing more poor people to get coverage. Pennsylvania has submitted a proposal for Medicaid reform, but it's still pending.

With no changes to the state program so far, some people fall into a "gap" where they don't qualify for federal help but also can't afford to buy their own insurance, Englerth said.

Local initiatives such as Healthy York Network and Family First's reduced-fee programs can help connect those people to all aspects of health care, she said.

"We're just really continuing to focus on the people that are falling in that gap," Englerth said.

She said if the state expands its Medicaid program, it would benefit many people in the community.

"We'd like more people to see the opportunity to get covered," Englerth said.

The journey through the Affordable Care Act helped Englerth realize a need for ongoing education about health care, she said. The center is in the process of developing more tools that will open to patients in the spring and summer, Englerth said.

"It's really obvious we all have a lot to learn," she said.

— Reach Mollie Durkin at mdurkin@yorkdispatch.com.

Get health help

For uninsured Yorkers interested in getting covered before the March 31 deadline, the first step is to visit healthcare.gov or call 1-800-318-2596.

Some people can navigate the process themselves, whereas others need assistance. Family First Health offers help through information sessions, group enrollment programs and appointments:

•Family First, along with Rep. Kevin Schreiber, will host an information session at 1 p.m. Friday on the third floor of the center, 116 S. George St. in York City.

•For those who need extra help, a group enrollment session will take place from 9 to 11 a.m. on Tuesday, March 25, at the center.

•To register for either event or make an individual appointment, call 717-845-8617 and choose option six. Help in Spanish is available.