The Utah Health Policy Project (UHPP) and its in-house consumer assistance program, Take Care Utah
, are poised to launch exciting new partnerships related to the navigator functions in the Affordable Care Act (ACA). The outlook for such a statewide collaboration just got brighter with the state’s recent request
to let the federal government operate Utah’s individual marketplace. As a result of this change, the federal government will be managing and funding Utah’s navigators, as Gov. Herbert suggested
last week in his remarks to the American Enterprise Institute (AEI).
Currently, Take Care Utah is partnering with the United Way of Salt Lake
, and other statewide organizations to help consumers find and keep affordable health care coverage. Although a final decision hasn’t been made, this coalition is well positioned as the logical hub for navigators operating around the federally-run individual marketplace. Look for more announcements on this process soon.
But UHPP/TCU also recognizes the importance of traditional brokers to Utah’s insurance marketplace. We’ve also become aware of a growing interest in the broker community to enroll clients in public programs like Medicaid and Medicare. So last week UHPP/TCU met with the leaders of Stone Hill National
, Utah’s largest brokerage firm, which represents about 1,500 agents. To our mutual surprise, UHPP and Stone Hill share many goals when it comes to implementing the ACA. Because many Utah families could end up on both
public and private insurance programs, TCU and Stone Hill agreed to look at linking our enrollment and navigation programs to provide better services to these families. Given the complexities of Utah’s future dual exchange system, this partnership between community-based navigators and traditional brokers only makes sense. This unique partnership builds on the recognition that low-income uninsured families might need public programs today—but down the road their income situation could (and should!) improve to the point where they will need private insurance. Or, some family members, like kids, may be eligible for CHIP, but the parents may have access to subsidized private insurance.
As anyone who has ever gone door-to-door selling magazines, popcorn, or Girl Scout cookies, knows that getting people to commit isn’t easy (with the possible exception of thin mint cookies). But at least people know what magazines and popcorn are for. So imagine if your task is to sell health insurance to people who never had it before
. How would you explain co-pays, deductibles, or inpatient services? And how would you say it in Amharic one day, Spanish the next, and Bhutanese the week after that?
That is the task that will face Utah’s navigators when open enrollment begins on October 1, 2013. With an estimated 29 million people enrolling in a health insurance plan through marketplaces by 2019, the Affordable Care Act wisely foresaw the need for people to help the uninsured and underinsured “navigate” the new health insurance world. Many Utahns, especially the uninsured, are unfamiliar with the complexities of the health system, from online applications to multiple coverage options. In addition, 76% of Utah’s nearly 400,000 uninsured residents earn less than 200% of the federal poverty level. But with developing partnerships between UHPP/TCU, the United Way of Salt Lake, 2-1-1, and now Stone Hill National, Utah will be better prepared to meet this challenge.
If you want to know more about navigators, read this excellent overview
by Community Catalyst, this FAQ
by Families USA, or this paper by UHPP