Health Care Navigators: An Unexpected Issue on the Road to Universal Healthcare

October 10, 2013

Thursday, October 10, 2013, by Samuel Williams
How does the Healthcare exchange work?
What is the income cap for Medicaid so that you would need to purchase at least some insurance?

Explain the different tiers of available healthcare plans. Do these give you better quality care based on how much you spend?

Who are the providers? Can any insurance company get involved in this?

What if you decide you’re not able to afford any of it?

These questions and more were asked by millions of Americans last week with the opening of the healthcare exchanges. In fact, in the first day and a half after the opening of the site, 6.1 million people visited, the official government site for healthcare exchanges. The traffic was so great that the online marketplace experienced glitches, malfunctions, and crashes.
Commonly known as the Marketplace, the healthcare exchanges were a central part of President Barrack Obama’s Affordable Care Act. The Marketplace provides a central online location where uninsured Americans can see what health plans are available in their area. Through the Marketplace individuals and families can determine whether they can get lower costs on monthly premiums or lower out-of-pocket-costs. With the passage of the legislation, all Americans are required to have some minimum standard of health care and enrollment will remain open to consumers through March of 2014.
While the theory behind the Marketplace seems simple enough, the reality is significantly more complex. Health insurance is a complicated concept for any American, let alone ones who have never had the opportunity to actually have health insurance. Enter Healthcare Navigators.  Navigators are “trained and credentialed [individuals who] educate consumers about their options, help consumers complete electronic and paper forms to establish eligibility for the federal exchange and public assistance programs, and help consumers enroll in federal exchange coverage.”  One Navigator described her experience, saying “It’s exciting; we’re making history.”

As of October 4, 2013 there were only 54 fully-trained and licensed Healthcare Navigators in Florida, a state of over 19 million people.

Of course, a program of enthusiastic Navigators is only effective if there are individuals willing to volunteer. An unexpected hitch in the implementation of the Marketplace has been the dearth of individuals willing to participate in the program. As of October 4, 2013 there were only 54 fully-trained and licensed Healthcare Navigators in Florida, a state of over 19 million people.  And this issue isn’t limited to Florida, as many states, including North Carolina, have seen similar shortages.
While much of the blame will be laid at the feet of the Federal Government, state governments, such as the one in North Carolina, have certainly exasperated the problem.  The Navigator Program is funded by federal grants.  By choosing not to cooperate with the Affordable Care Act and declining to extend Medicaid coverage to about a half-million North Carolinians, the state rejected $27 million in federal assistance for promotional activities. “As a result, North Carolina’s outreach and enrollment are being handled by hospitals, nonprofits, volunteers and local agencies,”  and these efforts are receiving less than a quarter of the funding they would have received with state support. Additionally, the lack of state support has led to predictions that implementation of the new law will be slowed down and insurance companies will be discouraged from participating.
It seems almost sad that after being passed by both congressional houses, overcoming a Supreme Court challenge, and playing a central role in the current shut down of the federal government, the real threat to implementing the Affordable Care Act may be in finding enough warm bodies to explain it.