Some States Face Hard Choices After Federal Health Navigator Funds Are Slashed : Shots - Health News North and South Carolina have very different outlooks since the Trump administration cut funding for the helpers who assist people signing up for health insurance.
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Reductions In Federal Funding For Health Law Navigators Cut Unevenly

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Reductions In Federal Funding For Health Law Navigators Cut Unevenly

Reductions In Federal Funding For Health Law Navigators Cut Unevenly

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KELLY MCEVERS, HOST:

Next Wednesday begins open enrollment season on the health insurance marketplaces that are part of the Affordable Care Act, or Obamacare. This year, the federal government has dramatically reduced funding for navigators. These are people trained to help other people sign up for coverage. Those funding cuts have hurt some states more than others. South Carolina has a much smaller budget than neighboring North Carolina, for example. From WFAE in Charlotte, N.C., Alex Olgin reports.

ALEX OLGIN, BYLINE: Twenty-six-year-old Ilia Henderson is one of those young, healthy people insurance companies want. She's getting ready to sign up for coverage again with the same Charlotte-based navigator she worked with last year.

ILIA HENDERSON: I definitely wanted to book with you again this year...

JULIEANNE TAYLOR: Yeah, absolutely.

HENDERSON: ...To kind of go through the process again.

TAYLOR: Yeah.

OLGIN: With navigator Julieanne Taylor's help Henderson, a massage therapist and student, got signed up for a medical and dental plan within half an hour last year.

HENDERSON: I was super happy, walked out, called my mom like, my insurance is cheaper than yours (laughter).

OLGIN: She's paying just over a hundred dollars a month in 2017 and looks forward to working with Taylor to find a similarly good deal for 2018. Taylor and Henderson are in North Carolina, where federal funds will employ more than a hundred navigators. They'll help more than half a million people who signed up for coverage across the entire state. Among the navigator groups in North Carolina, only 10 percent of federal funding was cut. Jennifer Simmons coordinates North Carolina's largest navigator program and says she's happy to report there will be someone available in each of the states' 100 counties during the six weeks of open enrollment this year.

JENNIFER SIMMONS: We are remaining really laser-focused on making sure that consumers across North Carolina are able to get the information they need.

OLGIN: This year, the federal government changed how navigator groups are funded. The money groups got for this year was based on how many people they signed up last year. The agency says this is to ensure accountability. Simmons says navigators will be in libraries, public health departments and even churches around the state.

SIMMONS: There are a lot of people that need renewal services. But we are also trying to reach new people.

OLGIN: The story is completely different just 15 miles away in South Carolina. Navigator groups in that state saw significant funding cuts. One group had almost its entire budget eliminated. The state's largest navigator group, the Palmetto Project, lost half its funding. The reasoning is still a bit of a mystery to Shelli Quenga, who runs that program. She can now only employ 30 navigators, half as many as last year, so she's being strategic about where she plans to place them.

SHELLI QUENGA: Areas that are A, more densely populated and B, had a higher level of ACA enrollment for 2017.

OLGIN: Which means about two-thirds of the state's counties will not have a navigator.

QUENGA: We are between the rock and the hard place even having to focus more on the urban areas. We know that people in rural areas don't have as much Internet access. The people who need help are probably in the rural areas. But we can't afford it.

OLGIN: Quenga is still planning to help people in those areas by using screen-sharing technology to walk them through signups. People can always call the federal call center for help, but Quenga says that her employees really take the time to work through the complicated cases. For example...

QUENGA: Lots of people have family members who are sleeping on their couch. Do you count that person as a tax dependent or not? You know, choosing whether to include that person as a dependent can have big consequences in terms of your financial assistance. The call center is simply not set up to run those scenarios with you.

OLGIN: And with less advertising help from the feds, Quenga feels the pressure mounting to get more people signed up for coverage during a shorter enrollment period so her navigator group will be better funded next year. For NPR News, I'm Alex Olgin in Charlotte, N.C.

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