Is another ACA Program doomed to failure?

There is a new group of individuals who are being trained and mobilized across the country to assist Americans with enrollment in the new Affordable Care Act Health Insurance Exchanges, but with limited training, limited funding, and some dubious allocations of money some wonder if the program will be successful.

The implementation of the Affordable Care Act has given rise to a new role in healthcare, that of the healthcare Navigator.  Navigators are individuals who are trained to assist people with enrollment in the new health insurance exchanges.  According to a recent article in Behavioral Healthcare Navigators have five key tasks:

1. educating the public about qualified health plans

2. distributing impartial information about enrollment, tax credits, and subsidies

3. helping people enroll

4. referring people who need additional help to another agency that can help with an appeal; and

5. providing culturally appropriate information

under the Affordable Care Act, states are required to set up a navigator program.  The government has provided $67 million dollars in grants to organizations to achieve this goal and money has been allocated to 105 different organizations in the 34 federally facilitated state marketplaces.  A full list of agencies which have won navigator grants can be seen here, but an initial look is more than disappointing.  Several individuals have voiced concern over the program which has effectively funded several programs and organizations with very specific historical missions and agendas which have the potential to not only be biased, but also may favor specific populations rather than the uninsured as a whole.  Several of these organizations furthermore have not historically been involved in healthcare.  Let’s take a look at a few. Let’s talk about the $67 million dollar navigators.

Who are the $67 million dollar navigators?

• If you live in Alaska, you will have the assistance of a healthcare navigator from either the Alaska Native Tribal Health Consortium, or the United Way of Anchorage.
•  Alabama’s largest navigator grant has gone to AIDS Alabama which received $501,380 and whose mission is to “help people with HIV/AIDS live healthy, independent lives and works to prevent the spread of HIV.  Alabama also provided significant awards to several Catholic organizations so that they could start navigator programs including an award of $20,750 which went to Catholic Social Services Archdiocese of Mobile.
• Arizona was awarded several grants including an allocation of  $190,268 to the University of Arizona to specifically reduce the number of Asian American and Pacific Islanders uninsured in Pima County and has also provided $71,386 to Campesinos Sinn Fronteras, Inc an organization “providing services to farm workers and low income Hispanics, while serving the general population as well”
• Florida’s grant winners included the Legal Aid Society of Palm Beach County which received $446,783 and the Epilepsy Foundation of Florida which received $637,686 and Mental Health America which will specifically “target under-served individuals with behavioral health disorders who are uninsured or under-insured” with its $683,691 grant
• In Georgia $2,159,360 has gone to an organization called Structured Employment Economic Development Corporation. or SEEDCO which has in the past been focused on economic development through programs such as community outreach and micro loans and will also be assisting in a Tennessee navigator program.
• Iowa will be utilizing two nurse associations as well as planned parenthood to provide navigators to the population with the following awarded grants: Planned Parenthood of the Heartland– $214,427; Visiting Nurse Services of Iowa- $257,142; and Genesis Health System through the Genesis Visiting Nurses Association for $128,430.  In fact several Planned Parenthood organizations received grants to serve as navigators (including in MT and New England)
• Illinois has seen grants awarded to several universities and county health departments, but also saw funds go to the Safe Haven Foundation ($324,736) a homeless outreach program, the Puerto Rican Cultural Center, a “community based institution to serve the needs of Chicago’s Puerto Rican/Latino community” ($600,000) and the Illinois College of Optometry which received $504,016
• Indiana’s future insured will find themselves assisted by organizations such as Plus One Enterprise, LTD ( a “woman owned, black owned small business” with no website or information available) which received $130,875 or will be assisted by veterans or community college students working through Affiliated Service Providers of Indiana ($897,150) or through the United Way which also received a grant of $424,586
• Two organizations will be assisting the efforts in Maine including Western Maine Community Action which received $475,000 and Fishing Partnership Health Plan which received $66,846
• Mississippi’s Oak Hill Missionary Baptist Church Ministries, awarded $317,742 is one of only two organizations which received a grant for the State and will be sending clergy members as navigators across the state’s Delta region
• New Jersey residents will receive help with navigating health insurance exchanges from organizations such as the FoodBank of Monmouth and Ocean Counties, Inc., which may be similar assistance that those in Ohio receive from the Ohio Association of Foodbanks which was allocated a whopping $1,958,961
• South Carolina will have several programs including those run and funded by The Cooperative Ministry which received $508,313 and the Beaufort County Black Chamber of Commerce which received $234,099.21
• In Texas a large portion of grant funding went to organizations which traditionally served the social needs of the community such as The National Urban League ($376,800), Southern United Neighborhoods ($600,678), United Way of El Paso County ($642,121), and Change Happens ($785,000) which was formerly known as Families Under Urban and Social Attack which has received past criticism for some of its views and agendas
• Virginians may receive assistance with signing up for healthcare from the Virginia Poverty Law Center which was granted an astounding $1,278,592 to create a navigator program for the state, although their historic focus has been on serving “Virginia’s legal aid system by providing advocacy, training, and litigation support on civil justice issues that affect low-income Virginians based in Richmond.”  Similarly in Wisconsin, Legal Action of Wisconsin will be assisting those residents navigate healthcare

Many say that the money that has been provided will not be enough.  I wonder if the money that has been provided has been allocated to those best prepared to educate the public about health insurance in a non-biased way and if these programs will be enough to meet the needs of all uninsured individuals within the states that they are serving.

 It is also important to note that funding for the navigator program was initially set at $54 million dollars, but that an additional $13 million dollars has been taken away from a fund set up to pay for public health and preventative care initiatives.

The fund, as reported by the New York Times was “originally $15billion dollars over 10 years is supposed to support wellness and disease prevention programs around the country.”  The reallocation of money so early in the game is already drawing criticism from some congressional members.  Stakes will remain high for this program to be effective, as for the Affordable Care Act to succeed it is necessary for millions of new people to buy insurance through the new exchanges. Already over budget and with several large organizations running this program who have little to no historic involvement in either healthcare or the insurance marketplace is leading to a doomed prediction for the Navigator program.

Follow BHM Healthcare Solutions for more news and updates about the $67 million dollar navigators.