$1.9 million headed to Delaware to help people navigate Affordable Care

Betsy PriceHeadlines, Health

a store in a brick building

Westside Family Healthcare will hire 12 new navigators to help people in every county get health insurance. Photo by Jeff Gentry

 

Two Delaware organizations will get $1.9 million to help people access health insurance through the Affordable Care Act plans.

Westside Family Healthcare, which for more than a decade has helped people wade through the pages of technical information and then the policy applications themselves, will get $1 million. It will be paid over three years.

Quality Insights Inc. of Middletown will get $856, 770, its first federal grant to provide navigators to help people sort through ACA, Medicaid and the state’s Children’s Health Insurance Program.

The result, officials said during a press conference Friday at Westside, should be that the two organizations will help thousands of Delaware residents and families find a health policy, or find a more affordable one.

The bonus: Several federal programs now are subsidizing the policies at high levels, meaning many lower-income people may quality for free or extremely inexpensive premiums and more higher-income people than ever can qualify for cheaper premiums.

Those subsidy programs, which are paid directly to the insurer, are expected to last through 2022. U.S. Congresswoman Lisa Blunt Rochester said during the press conference that many national groups are pushing for the federal subsidies to be made permanent.

Policy navigators are needed and helpful because of the complicated nature of the Affordable Care Act Plans, also called Obamacare. The subsidies take into account income and many other factors, while the insurance policies are offered on several levels with different premiums, services and deductibles.

A navigator won’t recommend a specific policy, but will confer with people in person or remotely. They’re able to help clients fill out paperwork and narrow down policies — and avoid mistakes that can cause paperwork to get kicked back and delayed.

Most times, a navigator will spend a couple of hours or more helping a single person or family through the system to a decision point.

 

a group of people standing next to a person in a suit and tie

Touring a Westside Family Health office are, from left, CEO Lolita Lopez, CMS Administrator Chiquita Brooks-Lasure, U.S. Congresswoman Lisa Blunt Rochester and Westside board chair Dr. Tom Sweeney. Photo by Jeff Gentry

When Obamacare started in 2010, navigators and subsidies were plenty. Former President Donald Trump’s administration was opposed to the plan and reduced funding for navigators and marektting as police costs rose. COVID-19 changed that and when President Joe Biden took office, more subsidies and sign-up periods were announced.

On Friday, CMS Administrator Chiquita Brooks-LaSure acknowledged that funding had been up and down for navigators and praised Westside for continuing the mission to help get people insured.

Westside Navigator Sara Cruz talked about how one client realized she could afford a policy in December and bought it. In January, she was hospitalized for four days with COVID-related pneumonia and ended up with a $35,000 hospital bill. Most of it was covered by her policy.

Then in April, when new subsidies went into effect, the client’s policy went from $70 a month to zero. That allowed her to be able to afford a $50 new medicine she needed, Cruz said.

Some clients can save $5,000 annually with the current subsidies, said Lolita Lopez, Westside CEO.

She said Westside would use the money to hire 12 new navigators. Five will have offices in current clinics and seven will work elsewhere in order to cover the state. The grant includes money to create offices for the navigators.

Lopez said the money will pay for 350 public education activities around the state where they hope to reach at least 10,500 people. with  nother 50,000 through marketing and promotional materials.

Westside administrators hope that will lead to interactions with at least 20,000 people and at least 1,400 consumers with new policies through ACA, Medicaid and/or the Children’s Health program. Navigators often discover that families are eligible for multiple programs.

The Delaware grants are part of $80 million being distributed across the country. It’s the largest-ever investment in the navigator program, according to a press release from the Centers for Medicare and Medicaid Services.

To reach a navigator in New Castle County, call 302-472-8655. In Kent and Sussex counties, call 302-267-8220.

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