ACA Magnifying Glass At thehalfway point in the six-week enrollment period, 2.4 million peoplechose a plan for the 2019 coverage year on healthcare.gov, thefederal health insurance exchange, according to data released lastweek. (Photo: Getty)

|

Enrollment is down sharply on the federal health insurancemarketplace this fall, and the consumer assistance groups that help withsign-ups think they know why.

|

They don't have the staff to help as many customers as beforebecause the Trump administration slashed funding. The federalgovernment is spending $10 million this year on navigators who help individuals enrollin coverage. The government spent $36 million in 2017 and $63million in 2016.

|

Trumpcare The dismantling of the ACA: Atimeline

|

“We don't have the people to provide the enrollment assistancenor to do the outreach and marketing to let people know what'shappening,” said Jodi Ray at the University of South Florida, whohas overseen Florida's largest navigator program since 2014.

|

Ray's program received $1.2 million in federal funding thisyear, down from $5 million a year ago. Florida leads the nation inenrollment in the Affordable Care Act marketplace plans.

|

With less money, Ray can afford to pay only 59 navigators acrossthe state this year, down from 152 a year ago. With fewernavigators, much of the group's counseling is done by phone insteadof in person. That complicates their job, she said, because it ismuch easier to talk with and show marketplace customers in personwhen looking at dozens of health plans with different costs andbenefits.

|

Open enrollment in the Obamacare plans began Nov. 1 and will rununtil Dec. 15 for the 39 states covered by the federal exchange,healthcare.gov. The other exchanges — run by states — typicallyextend until the end of December or into January.

|

Obamacare plans are for people without workplace or governmentcoverage.

|

Nationwide, navigator groups are scrambling to make up for theloss of federal funding to ensure they can help people make senseof their health insurance options.

  • In South Carolina, the Palmetto Project has transformed intothe state's first nonprofit insurance agency. Several of its formerfederally funded navigators are now licensed insurance agents. Intheir new role, they get paid a commission on their sales and don'thave to follow Trump administration rules that encourage navigators to talk to customers about short-termplans with limited benefits. The agents can also help customersenroll in Medicaid, Medicare and off-exchange plans.
  • The Community Council of Greater Dallas, which was funded lastyear to help with enrollment in 56 counties, has raised money fromprivate donors to continue serving seven counties around Dallas.But it has 25 fewer navigators, so consumers seeking help must waitthree days on average, compared with less than a day last year.Across Texas, 211 of 254 counties have no federally paidnavigators.
  • In Wisconsin, the organization Covering Wisconsin has raisedmillions of dollars from cities, counties and local United Waychapters, as well as the state Medicaid agency, to make up for thefederal cuts. Even still, it will be able to provide in-personassistance in only eight counties around Milwaukee and Madison.Twenty other counties are served by telephone.
  • The Kansas Association for the Medically Underserved is relyingtotally on volunteers to help consumers with in-person andtelephone assistance. In the past year, the association was able touse government funding to pay about 20 navigators.

Nationally, nearly 800 counties served by the federal marketplace will not haveany federally funded navigators this fall — up from 127 counties in2016, according to the Kaiser Family Foundation. (KHN is aneditorially independent program of the foundation.)

|

Federal officials said they were not providing funds for navigators in Iowa, Montana or NewHampshire because no organizations applied in those states.

|

Nearly 12 million people across the country — including nearly 9million on the federal exchange — enrolled in Obamacare plans for2018.

|

At the halfway point in the six-week enrollment period, 2.4million people chose a plan for the 2019 coverage year onhealthcare.gov, the federal health insurance exchange, according todata released Wednesday by the federal Centers for Medicare& Medicaid Services. That compares with nearly 2.8 millionconsumers who selected their coverage through the exchange duringthe first 25 days last year.

|

Among states with the largest enrollment drops: Pennsylvania(down 25 percent from last year), Missouri (down 25 percent) andOhio (down 20 percent).

|

The annual enrollment tally is being closely followed in partbecause 2019 marks the first year since the marketplace plans beganin 2014 that Americans won't be fined for failing to havecoverage.

|

But consumer experts think the lack of navigator funding couldend up having a bigger impact on enrollment. Caroline Gómez-Tom,navigator program manager of Covering Wisconsin, said the end ofthe so-called individual mandate penalty has been a “non-issue”among people seeking coverage.

|

“Some folks mention it, but at the end of the day they stillwalk away with health coverage,” she said. “The ability to havecoverage at affordable prices outweighs the penalty being gonebecause people still see health care insurance as important tohave.”

|

Consumers generally have a greater choice of plans for 2019 asmore companies enter the individual market and existing plansexpand service areas. Plus, premiums are dropping in some areas,and where they are rising the rate of increase is among the lowestin several years.

|

Katrina McGivern, director of policy and public affairs for theKansas Association for the Medically Underserved, said people inrural areas of the state will have the most difficulty getting helpas a result of funding cuts.

|

After five years of experience, she said, she is hopeful thatpeople are figuring out how to do it on their own. Still, sheadded, there are always “people who need assistance to get throughit.”

|

Kaiser Health News isa nonprofit news service covering health issues. It is aneditorially independent program of the Kaiser Family Foundation,which is not affiliated with Kaiser Permanente.

|

Read more: 

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.