Opening day is rapidly approaching for the new insurance marketplaces created by the Affordable Care Act. You can sign up now for an account at healthcare.gov, that you should be able to use starting October 1st to purchase health insurance from the state and federally run online marketplaces.
Those exchanges will offer a menu of plans that is intended to be simpler than the market today.
“The problem is, they’re giving you simplified information about things that are inherently complicated,” says George Loewenstein, professor of economics and psychology at Carnegie Mellon University. Loewenstein’s research suggests that most people are confused by basic insurance concepts and do a poor job of purchasing the best plan for their needs.
If the Affordable Care Act is to bring tens of millions of uninsured into the system -- as the Congressional Budget Office has forecast -- it will take more than a simpler menu of plans to make the process manageable. That’s where the “navigators” come in.
“Navigators” are made up largely of local organizations that are already doing outreach on education and healthcare. “I think these navigator programs are really critical to getting people enrolled into coverage,” says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation.
But in the 34 states where the insurance exchanges will be partly or wholly federally run, the organizations that will act as “navigators” haven’t even been named, much less received special training. The Obama administration has reduced training requirements from 30 hours to 20 hours to help expedite the process, but the short timeline may aggravate a funding crunch, as states compete for $54 million in grants to fund the programs.
“States like Texas, Florida, Georgia,” says Tolbert, “where you’ve got a limited amount of money and very large numbers of insured.”
In Florida, the Healthy Start Coalition in Orange County has applied to fund five “navigators.”
“We’re one of the highest rates of uninsured in the country,” says executive director Linda Sutherland. “A lot of those people are used to just accessing the emergency room for care.”
Sutherland thinks the hardest task for navigators dealing with this population won't be unpacking the details of various insurance plans, but demonstrating that insurance is worth the cost. “We’ve definitely got some convincing to do,” she says.