Obamacare navigators see deep cuts in funds to guide recipients

In a letter she just received, Trinh Pham saw the yearly funding for her organization’s work guiding Obamacare enrollees drop from about $150,000 to roughly $10,000. Starting right now.

“I’m shocked,” she said. She’s not the only one.

Her organization, Boat People SOS-Atlanta, is one of a handful that employs “navigators” to educate Georgians on signing up for health insurance on the Affordable Care Act’s exchange market. After being told months ago to plan for a stable funding level, they say, they suddenly — on Aug. 31, a day before grants were expected — received notice that funding would decline. Then this week the actual numbers came out.

“We already prepare for the new enrolment (which starts Nov. 1),” Pham said, describing the dissonant news. “We know that our continuation will be approved, we’re ready, we actually just added one more navigator on staff. I actually don’t know what to do right now.”

On a policy level, the move is not a surprise following the election of President Donald Trump and his selection of Tom Price as health secretary. Both are deeply skeptical of the 2010 health care law, and the law itself invests tremendous amounts of leverage in individual decisions by the secretary.

This is one of many choices that Price can make, decisions that may have an impact on the law’s success or failure without resorting to legislation. On Aug. 31, his department, Health and Human Services, announced that it would gut funding for enrollment education from more than $100 million last year down to $10 million this year. In addition, the announcement said it would change the department’s funding for the navigators, which has been at $62.5 million nationwide. Only now the navigator organizations are learning by just how much.

In the announcement, the department said the money had previously been spent ineffectively, and that it would now be targeted in more effective ways. It noted that sign-ups of people brand-new to Obamacare had declined drastically, and it asserted that the $62.5 million-funded enrollment by navigators of 81,400 people. GOP health care officials have called out one figure in particular, that 17 of the nation’s navigators had enrolled only 100 people each, thus costing about $5,000 per enrollee.

Advocacy groups question those figures, noting that people may get help from a navigator that is critical but then finish their sign-up somewhere else. They also criticized the new metrics, saying that judging them solely by the number of people they enroll changes their goal from correctly educating people on how the system works — and finding the best option for them — to enrolling people in Obamacare.

No one knows for sure what the impact of the cuts will be. But many experts, and the navigators, say fewer people will understand their options and that enrollment will decline.

“The rural people will get left behind” because that’s where it’s most expensive to travel and where the ratio of people reached per visit starts to decline, said Sarah Sessoms, who runs Georgia’s largest navigator organization, Insure Georgia, with about 42 navigators. “They really will. The people who are suffering already because of the Georgia landscape of the Georgia insurance market, in those areas, will not get help.”

Sessoms spent Friday in Washington at a previously planned meeting of navigator organizations, and the conversation turned to the stunning letters. “The funny thing is we were all trying to figure out the rubric,” she said. “They said it was going to be based on enrollment metrics. We met them.”

Insure Georgia’s funding will be cut from $2.2 million to about $329,000, she said, so it will look — quickly — for alternative funding, but layoffs seem inevitable.

“Unless we can find a bit of funding in other places, I don’t see any other way of going from around $2.2 million to $300,000,” she said. “We run a very lean organization. There’s not a lot of fat.”

The department said it would now focus on digital messaging, which it says is most effective. Surveys, however, show rural areas tend to lag behind in digital infrastructure.

The Atlanta Journal-Constitution reached out to the Trump administration for figures and a response to the criticism. Representatives in Atlanta referred questions to Washington, where officials did not respond.

Bill Custer, a health economist at Georgia State University, said the effect on the market overall was also important.

“The people most likely affected, the people now less likely to sign up, tend to be healthier individuals,” Custer said.

Those are the cheaper ones to insure.

“What happens,” he said, “is if you don’t get enough healthy individuals, premiums go up.”

Custer also noted that if a navigator’s goal is simply to enroll people in Obamacare exchange plans, they might not tell someone whether they might find a cheaper plan off the exchange. Georgia navigators said they knew of no organizations that would do that.

Reader Comments ...

Next Up in Georgia Politics

Trump promises Americans ‘huge tax cut’ for Christmas
Trump promises Americans ‘huge tax cut’ for Christmas

President Donald Trump on Monday promised a tax overhaul by Christmas, a day after the White House signaled its willingness to strike a health care provision from Senate tax legislation if it’s an impediment to passing the tax bill. Speaking before a Cabinet meeting, Trump said: “We’re going to give the American people a huge tax...
President Trump discounts accusations against Roy Moore
President Trump discounts accusations against Roy Moore

President Donald Trump discounted allegations of sexual assault against Alabama Republican Senate nominee Roy Moore and said Tuesday that voters should not support Moore’s “liberal” rival. Trump addressed the swirling controversy surrounding Moore for the first time since top Republican leaders called on Moore to step aside more than...
Warden for troubled Georgia prison hospital reassigned
Warden for troubled Georgia prison hospital reassigned

The warden who has been in charge at Augusta State Medical Prison for the last 18 months has been reassigned, a signal that state corrections officials want new leadership at the facility as it deals with the sanitation and safety concerns recently brought to light by The Atlanta Journal-Constitution. Georgia Department of Corrections...
Lawsuit seeks to end Georgia’s restrictions on third-party candidates
Lawsuit seeks to end Georgia’s restrictions on third-party candidates

Georgia’s restrictions on third-party candidates trying to run for the U.S. House of Representatives should be declared unconstitutional, according to a lawsuit filed in federal court Tuesday by the Libertarian Party of Georgia. No third-party candidate in Georgia has ever collected enough signatures to appear on the ballot for the U.S....
The Left questions the reasons behind deporting Haitians who were here legally
The Left questions the reasons behind deporting Haitians who were here legally

Thousands of Haitians have now lost their Temporary Protected Status, the deportation protection that allowed them to live and work in the United States following the devastating earthquake of 2010. A roundup of editorials Tuesday takes a look at the issue. From The New York Daily News: Trump’s decision is not about undocumented immigrants. The...
More Stories