CLEVELAND, Ohio – A service that helps Ohioans enroll in Medicaid and the healthcare exchanges is shutting down and most of its 54 employees will be laid off, executives say.
The federal cuts affect the Affordable Care Act Navigator program, a service that helps people understand and enroll in Medicaid and the Obamacare health insurance exchanges. In Ohio, severe cuts mean the program will shut down.
“That’s really sad news for Ohioans,” said Rachel Rosen DeGolia, a Navigator for the Cuyahoga Health Access Partnership (CHAP).
The Ohio Association of Foodbanks, which oversees a statewide consortium of Navigators, received notice last week of a 71 percent cut in its grant funding, slashing its $1.7 million budget to $485,967 for the year.
The organization enrolled just shy of 10,000 Ohioans in marketplace or Medicaid plans last year. Faced with operating with less than one-third of its previous funding, the group decided Thursday it would have to shut down the program.
“There won’t be any Navigators in the state of Ohio,” said Lisa Hamler-Fugitt, executive director for the Ohio Association of Foodbanks.
Most of those employed in Ohio as Navigators will be laid off, Hamler-Fugitt said.
“They’ve been absolutely dedicated foot soldiers in the community. It’s pretty heartbreaking,” she said.
Resolute Certified Navigators, the only other Navigator program in the state, apart from the members of the Ohio Association of Foodbanks consortium, suspended its Navigator operations earlier this month.
Resolute Certified Navigators, which has an office in Dayton, stopped running the program because it hadn’t received grant funding from the Centers for Medicare and Medicaid Services yet, according to Glenn Hughes, project director for Resolute Certified Navigators. The previous funding year ended Sept. 1.
“These are people’s lives that are hanging in the balance. Let’s not forget,” Hamler-Fugitt said. “Individuals are entitled to have access to educated individuals who are licensed in their community to provide them with unbiased, fair and accurate information about what’s available to them.”
The cuts come as part of a move by CMS to bring more accountability to the Navigator program, CMS said in a statement. During the last open enrollment period, Navigators nationwide received more than $62.5 million in federal grants and enrolled 81,426 people, CMS said.
Funding for the current year was based on how well Navigators met their previous year’s enrollment goals, CMS said. Last year, first-time enrollment dropped 42 percent, CMS said.
The Ohio Association of Foodbanks consortium enrolled 88 percent of the number of people it was expected to in Medicaid or marketplace health plans during the last enrollment period, Hamler-Fugitt said.
CMS did not respond to Plain Dealer requests for information on Ohio Navigator funding cuts and alternative options for those affected to access Medicaid and marketplace services.
An estimated 700,000 people have gained health insurance through Ohio’s Medicaid expansion and another roughly 240,000 get insurance through the Obamacare exchanges. Each year, Navigators help those who lose their jobs, see changes in their household or experience changes in income that affect their eligibility in certain plans.
Open enrollment for the exchanges runs Nov. 1 through Dec. 15. People can enroll themselves in marketplace plans using the federal site www.healthcare.gov, by calling the national hotline 1-800-318-2596 or hiring an insurance agent or broker.
“You can go on the website yourself but a lot of people have trouble with that,” said Rosen DeGolia of CHAP, who often helps people use computers. “A lot of people don’t understand insurance. We help people with insurance 101.”
Navigators worry that those who get a commission – such as insurance agents or brokers – won’t offer people unbiased help and won’t be an affordable alternative for many of the people they assist.
In Cuyahoga County, people are referred to CHAP through the county jail, the foodbank or the Department of Public Health, Rosen DeGolia said. She doesn’t yet know what the cuts will mean for her Cuyahoga County-based office of five Navigators.
“It definitely isn’t good news,” Rosen DeGolia said. “We do a lot of good. I’m just thinking about all of those people I’m going to have to call I have appointments with.”
While Navigator funding has been decreasing gradually over the years as fewer people enroll – last year the Ohio consortium saw an expected 15 percent cut – such a sudden drop in funding this year was too difficult to overcome, Hamler-Fugitt said.
The federal government gave the Ohio Association of Foodbanks until Sept. 27 to submit a new plan to the federal government outlining how it would operate using 29 percent of its previous funding. Notice of whether that plan is accepted would come within 30 days after that, just before open enrollment starts, Hamler-Fugitt said.
That window – and the conditions required in the new proposal, such as committing to being able to run the program for 12 months on reduced funding – made it impossible to continue, Hamler-Fugitt said.
“The funding is just not adequate to do that,” she said.
Navigator offices in the state already were suspending operations like Resolute Certified Navigators, having employees take furlough days, relying on reserve funds or searching for other funding methods as they waited for the late and reduced funding from the government to arrive.
“Funds are gone. We have been operating in good faith,” Hamler-Fugitt said.
Just the facts
- The Centers for Medicare and Medicaid Services is cutting funding for the Affordable Care Act Navigator program.
- The Ohio Association of Foodbanks would receive a 71 percent cut in its grant funding, slashing its $1.7 million budget to $485,967 for the year.
- Because the funding is inadequate, most of the state’s 54 Navigators will be laid off.
- The Ohio Association of Foodbanks enrolled about 10,000 Ohioans in marketplace or Medicaid plans last year.
- People can enroll themselves using the federal site www.healthcare.gov, or by calling the national hotline at 1-800-318-2596.
- Open enrollment for the exchanges runs Nov. 1 through Dec. 15.