Shamane Mills

Big Federal Cuts for State’s Health Care

Second straight year of cuts in Affordable Care Act for Wisconsin, other states.

By , Wisconsin Public Radio - Sep 16th, 2018 10:17 am
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Nurse. Photo by Rebecca20162393 (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

Wisconsin will again get federal money to help people sign up for health insurance offered under the Affordable Care Act, but the grants will be a lot smaller. And three states — Iowa, Montana and New Hampshire — won’t get any funding for navigator agencies.

A navigator is an individual or organization trained to help consumers, small businesses and their employees find health care through the ACA marketplace.

Wisconsin’s only navigator grant will go to Covering Wisconsin, which is receiving $200,000 to help people enroll this fall for health coverage which starts next year. That’s a 65 percent cut from what the agency received last year, said Allison Espeseth, development and operations manager at Covering Wisconsin.

To reach as many people as possible, Covering Wisconsin plans to subcontract Northwest Wisconsin CEP, a past navigator. Together they will provide in-person assistance to 23 of the state’s 72 counties. Those counties are in the southern, northern and western parts of the state. Telephone assistance will be available in other regions.

“Our approach is going to be little different this year. We’ll still be available on the ground and in person but we’ll also be reaching out and trying to make Wisconsin residents aware of help that is local to them. So we will try to find someone near to them who can help, like enrollment assisters,” said Espeseth.

Under the new criteria to obtain the grant, navigators can also help people enroll in non-ACA health plans. Association and short-term health plans are often cheaper but don’t necessarily provide all the benefits of ACA plans.

The federal Centers for Medicare & Medicaid Services (CMS) announced Tuesday it would be providing $10 million to the 34 states, including Wisconsin, that use the federally run marketplace. That’s less than a third of what the navigator program got last year and is a substantial decline from 2016 when states got a total of $63 million.

The Trump administration has taken steps to undermine the ACA, in addition to slicing navigator funding, it also cut advertising for the ACA sign up period.

CMS has defended the decrease by saying agencies helping people enroll for health coverage are not effective. Nationally CMS Navigator agencies enrolled less than 1 percent of all the consumers who signed up for 2018 coverage. Last year, Wisconsin’s two navigator agencies provided services to 30,000 people, according to a press release from Covering Wisconsin.

“Our numbers really have remained pretty steady,” said Espeseth. “We’ve had a navigator grant since 2014. In tracking out numbers and reporting back to the Centers for Medicare & Medicaid Services, we see the number of people we are assisting … have remained pretty high. And over the years we’ve gotten a lot of repeat customers.”

Espeseth said there are new policies introduced every year that consumers need help understanding and many have questions after they’ve enrolled regarding premium payments and how to use insurance to get medical services.

Open enrollment for coverage sold through the ACA marketplace begins Nov. 1 and lasts six weeks.

Listen to the WPR report here.

Federal Money For ACA Sign Up Assistance Declines Again was orginally published by Wisconsin Public Radio.

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