Navigators Helped 10.6M Individuals With ACA Coverage Options
Consumer assistance programs created under the Affordable Care Act helped about 10.6 million U.S. residents explore health coverage options and apply for insurance plans during the ACA's first open enrollment period, according to a Kaiser Family Foundation survey released Tuesday, the New York Times reports.
KFF sent online questionnaires to 4,445 of the programs between April 24 and May 12. Researchers received responses from 843 of the organizations. Researchers then weighted the responses to account for the different types of organizations, as well as the type of insurance exchange in the state in which the group was located, such as:
- State-run exchanges;
- An exchange run by the federal government; or
- A partnership exchange run by both the state and federal governments.
The survey found that the programs that existed during the ACA's initial six-month open enrollment period employed more than 28,000 full-time workers and volunteers, called navigators (Goodnough, New York Times, 7/15). On average, each navigator assisted nearly 400 individuals.
However, the report marked a significant difference in the programs' effectiveness depending on whether they were located in states that ran their own exchange. For example:
- 325 consumers received assistance for every 1,000 uninsured individuals in the 16 states and the District of Columbia that ran their own exchanges, averaging 8.7 workers per 10,000 uninsured residents;
- 276 consumers per 1,000 uninsured individuals received assistance in the five states that partnered with the federal government to run their exchanges; and
- 162 consumers per 1,000 uninsured individuals received assistance in the 29 states that used the federal insurance exchange (Demko, Modern Healthcare, 7/15).
Consumers mainly sought navigators' help because they were confused about the ACA and plans offered through the exchanges. In addition, many individuals who received help from navigators had technical issues or did not have the Internet in their homes.
According to the survey:
- Nearly 75% of the assistance organizations reported that "most" or "nearly all" of their clients who considered purchasing private coverage did not understand simple insurance terms, such as "deductible" or "in-network service;"
- Almost 66% of navigators said they spent between one and two hours assisting each client;
- About 40% of the programs reported not being able to help every individual who approached them;
- 12% of the programs said demand for their services exceeded their abilities to provide assistance;
- Nearly 90% of the programs said clients have already returned to them with post-enrollment issues (New York Times, 7/15); and
- 90% of the programs reported that the majority of their clients previously were uninsured (Modern Healthcare, 7/15).
Navigators Could Continue To Play 'Key Role'
The report predicted that navigators will continue to play a "key role" in future open enrollment periods, The Hill reports.
According to the report, that is because the public's "understanding of the ACA remains limited." Further, the report added, "If the first wave of enrollment in 2014 was comprised of those consumers who were the most resourceful and motivated to seek coverage, then investment in consumer assistance will be all the more key in the year to come" (Al-Faruque, The Hill, 7/15).
However, it remains to be seen just how effective the programs will be in the future, because funding for navigator organizations has not yet been determined, according to the Times. Last month, the Obama administration said it would make $60 million available for such programs, which is $7 million less than was available last year for states that will use the federal exchange.
Regardless, the survey found that three-fourths of the responding programs said they will continue to operate during the upcoming open enrollment period. The survey found that programs that are funded through the federal Health Resources and Services Administration, such as federally qualified health centers, likely will continue to offer their services (New York Times, 7/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.