Kansas State University


Issues in Health Reform

Category: Navigators

“Role of Health Care Navigators Under Fire”

Navigators are set to be trained to help people enroll in the new marketplace of insurance plans.  As noted in this Wall Street Journal article several states are now enacting rules that are intended to protect consumers’ confidential information (e.g., social security numbers and tax info) by setting high standards (fingerprinting, licensure) of the assisters, much as insurance brokers are already.  On the surface this is certainly not a bad thing but it does create another level of barriers to assuring a smooth enrollment process this fall.

Another way of looking at this though suggests that perhaps not all is as it seems.  Extension and others who help many limited income families already have access to that confidential information (VITA sites) without any such standards.  So apparently those of limited income didn’t need the same protections of those with higher incomes.  I find this curious.

Some think the effort may be a disingenuous ploy implemented to once again make it more difficult for consumers to enroll, and to make this first year’s enrollment process go less than smoothly.  I find it important to remember that this marketplace model of health insurance that became Obamacare was originally an idea of conservative groups who did not want to see Medicare extended to all populations, or were not supportive of any of a number of other health insurance reform proposals.  A similar system has been successfully implemented in Massachusetts (when Romney was Governor there)KFF Massachusetts Health Care Refore July 2012.  And though conservative groups have clearly not be supportive of Obamacare, it is the closest to allowing the free market to continue to provide insurance, the kind of plan one would expect them to support.

What role for Extension in consumer enrollment in the online health insurance marketplaces?

Our national colleagues have been giving quite a bit of thought to this.  There is a fact sheet those folks put together to help guide Extension leadership on thinking about Extension’s role in the Navigator program.  Health Insurance Navigator Fact Sheet 4 30 13  It defines what a navigator is and lays out the different options for Extension systems.

Know that in Kansas there are currently several groups considering submitting a proposal to the feds to be funded as one of the navigators.  Kansas will be awarded two grants, one has to go to a consortium type group.  Total funding will be $600,000.  That is likely not enough money to do the task so folks that extend the reach of those dollars, perhaps through train the trainer initiatives (yes, Extension) may be viable partners in these efforts.

Also useful is the J of Extension commentary published in the Oct issue by our Maryland colleague Bonnie Braun for thinking more broadly about Extension’s role in other aspects of the Affordable Care Act.

Further, you can link to this webinar, specifically the section done by my Wisconsin colleague Mary Meehan-Strub and myself on what role for Extension in all of our program, starting at hour 1:27. “Implications for UW Extension and county colleagues.”