Federal cuts scare state advocates

Some worry about confusion among Access Health clients

Dramatic federal cuts to grant money for organizations that help people sign up for health insurance won’t directly affect Connecticut consumers, according to local experts. However, they said the slicing of federal grants signals a possible death knell for the Affordable Care Act, and could muddy the message about what’s happening in Connecticut.

The Centers for Medicare and Medicaid Services announced Tuesday that the federal government was was planning to de-

crease the amount of funding available through the federally facilitated Exchange Navigator Program to $10 million for the coming enrollment year. During the 2018 open enrollment period, $36 million was available through the program, which supports assisters who help people enroll in health plans on the federal health exchange created through the Affordable Care Act.

In a news release, the Centers for Medicare and Medicaid said the funding was being reduced because navigators “failed to enroll a meaningful amount of people ... and not nearly enough to justify the millions of federal dollars spent through the program.”

Because Connecticut has its own health care exchange and doesn’t use the federal program, HealthCare.gov, it wasn’t receiving federal funding for its navigator program and won’t take a direct hit from the cuts. But that doesn’t mean the announcement of funding cuts won’t have an impact on Connecticut, said Andrea Ravitz, head of marketing for Access Health CT, the state’s

health insurance exchange.

“When this type of news comes out, people think it’s going to affect the state,” she said. “The mixed message this might create (could have) repercussions.”

Patricia Baker, president and CEO of the Connecticut Health Foundation, agreed. The foundation pushes for health care access for all state residents, particularly lowincome people.

Baker said that in the first year after the passage of the Affordable Care Act, Connecticut did receive federal funding for health navigators, but hasn’t in the subsequent years.

Now, those in the state who assist with enrollment — known as “enrollment specialists” or “certified application counselors” — are provided through health organizations such Southwest Community Health Center in Bridgeport and Optimus Health Care, with locations in Bridgeport, Stamford and other towns and cities.

Not only is the announcement of the federal cuts to the navigator program confusing to Connecticut residents, Baker said, it has a larger implication. The cuts come hot on the heels of President Trump’s administration suspending a program that provides subsidies to insurers to reimburse them for covering sicker patients, who are more expensive to insure.

“The message goes out once again that health care is in jeopardy,” said Baker of the cuts to the federal navigator program.

The Trump administration has made no secret of its interest in doing away with the Obama-era Affordable Care Act. Though efforts to repeal and replace the legislation weren’t successful, there have been indications that the administration is looking to undermine the program through what Baker called “death by a thousand cuts.”

Baker and Ravitz pointed out that cuts to the federal navigator program mark the second time the grant funding for the initiative has been dropped. In 2016, the program received $63 million. Despite that larger amount of funding, the Centers for Medicare and Medicaid argued, navigators enrolled less than 1 percent of the eligible population in plan year 2017. The same was true in enrollment year 2018.

But Baker said many clients actually begin the process with a navigator, even if they end up enrolling through a broker or insurance agent. Thus, she argued, navigators are essential to the process even when they aren’t the ones who seal the deal.

Signing up for health insurance can be tricky, Baker said, particularly when one has never done so before. She cited a 2017 survey by the University of Connecticut’s Health Disparities Institute showing that, of roughly 500 adults enrolled in a private health plan through Access

Health in 2016, 20 percent didn’t know what a health insurance premium was. Also, only one of three could calculate their out-ofpocket cost of a hospital bill when a deductible and a co-pay were part of their health insurance benefit.

The navigators play a crucial role in helping to educate consumers about what plans are best for them, Baker said.

“I do think these inperson assisters are very important,” she said.

Brian A. Pounds / Hearst Connecticut Media file Dionne Williams, left, of Bridgeport, signs up for health insurance with Access Health CT enrollment specialist Rosalina De Los Santos at the Bridgeport Public Library in 2014.