Short on federal funds, many health insurance navigators switch tactics

Enrollment is down sharply on the federal health insurance marketplace this fall, and the consumer groups that help with registrations think they know why.

They don’t have the staff to help as many customers as before because the Trump administration cut funding. The federal government is spending $10 million this year on navigators who help individuals enroll. The government spent $36 million in 2017 and $63 million in 2016.

“We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening,” said Jodi Ray at the University of South Florida, who has overseen Florida’s largest navigator program since 2014.

Ray’s program received $1.2 million in federal funding this year, down from $5 million in 2017. Florida leads the nation in enrollment in the Affordable Care Act marketplace.

With less money, Ray can afford to pay only 59 navigators across the state this year, down from 152 a year ago. With fewer navigators, much of the group’s counseling is done by phone instead of in person. That complicates their job, she said, because it is much easier to talk with and show marketplace customers in person when looking at dozens of health plans with different costs and benefits.

Open enrollment in the Affordable Care Act plans began Nov. 1 and will run until Dec. 15 for the 39 states covered by the federal exchange. The other exchanges — run by states — typically extend the deadline until the end of December or into January.

Nationwide, navigator groups are working to make up for the loss of federal funding to ensure they can help people make sense of their health insurance options.

Nationally, nearly 800 counties served by the federal marketplace will not have any federally funded navigators this fall — up from 127 counties in 2016, according to the Kaiser Family Foundation.

Federal officials said they were not providing money for navigators in Iowa, Montana or New Hampshire because no organizations applied in those states.