By Megan Halena. As the Health Care Program Coordinator at TakeAction Minnesota, I work with Navigators to learn about the realities of people’s health insurance needs and options, to assist in improving the enrollment process, and to connect them with opportunities to advocate for making our health care system work better for the people they are helping enroll.
What’s a Navigator, you might be wondering? The Navigator role was created as a part of the Affordable Care Act as a way for consumers using MNsure, the state-based health insurance exchange, to get free assistance with the enrollment process. Navigators have been a crucial part of many enrollee’s success stories. One enrollee writes: “I tried to enroll last year, but could not get through the website on my own, so went through the year uninsured. This year, I accessed enrollment help at the Salvation Army. The fact that I could call someone who I could meet with and who could walk me through the Exchange made all the difference.”
As the 2015 Legislative Session comes to a close, I am left thinking of the good work of Navigators do and what it looks like to support them.
In this session, the Senate passed a measure to level the per enrollment payments Navigators receive for enrollment work, but the House did not and the measure did not make it into the final Health and Human Services bill. One thing legislators can do to support the work of Navigators is to level the per enrollment payments Navigator organizations get for doing this intensive enrollment work. Navigators help anyone who walks through their door without charge. Instead they are paid by per enrollment payments and block grant support from MNsure. Most Navigators conduct other kinds of work, too, such as food shelf management or other benefit/support facilitation, and are supported by additional private grants. The support of Navigator positions would be much more robust if the per enrollment payments were leveled off. For enrollment in Medical Assistance (MA), Navigator organizations get $25, and for MinnesotaCare and Qualified Health Plan (QHP) enrollments, Navigator organizations get $70. MA enrollment is not easier or faster. In fact, MA enrollment can sometimes be more challenging, as there can be complicated interfacing with county systems.
Navigators are dedicated to seeing the enrollment process through to completion – not only because it’s their job, but because they care about the person who needs the coverage. Katelyn Matheny, a Patient Advocate and MNsure Navigator at the Native American Community Clinic in Minneapolis, is enthusiastic about the enrollment work she does. She describes here that the work can sometimes be arduous – and that is irrespective of which program a person qualifies for (so it would make sense for the payments to be level). Katelyn writes:
My favorite part of being a Navigator is letting families know when their insurance is active. Follow-up is definitely time consuming, but when you are assisting families with the whole MNsure process, you build a relationship with them and feel solely responsible for seeing this through until the end. Some issues that I run into are having counties share information with me regarding applications, but all of the headaches are well worth it when a case that I’m working on finally becomes active.
People put their faith and trust in you and I feel that it is very important to show your clients that they made the right decision by coming to you. There are many ups and downs with my Navigator position, but at the end of the day it makes everything worthwhile when I can make that one phone call and let families know that they can now go see that doctor or now get that surgery done that they have been pushing off because they don’t have insurance.
My most recent feat was helping a women that had not had health insurance since 1982! She had sent in numerous applications and some sort of issue had always arisen, keeping her from getting her well-deserved health insurance. She was reluctant to accept help from me, seeing as she had been disappointed time after time, but I assured her I would see this through if it was the last thing I did (a little dramatic, I know). This woman’s health had been dramatically deteriorating and most surgeons and healthcare specialists won’t even let you set up an appointment if you don’t have health insurance. So with a couple of calls to the county and about a week’s worth of patiently waiting, I checked to see if she was active and to my delight, she was! So I called her to celebrate and was disappointed to get her voicemail; I left her a vague message to call me back regarding her insurance because I wanted to share the excitement with her in person. When, to my surprise, I bumped into her in our clinic’s waiting room, I asked to meet with her privately and sat her down and told her the news that she now had coverage. She cried and gave me a big hug and I realized at the moment how important my job is as a navigator.
When Katelyn mentions calling the County, she is referring to parts of the process involved in getting Medical Assistance active. Medical Assistance is the program that sees the most enrollment by far – several thousand more enrollments than both MinnesotaCare and QHP enrollment combined. Since Nov 15th of this year, Navigators enrolled 148,530 people in MA, taking between 30 minutes and 2+ hours per enrollment, for which Navigator organizations were paid $3,713,250 – $6,700,000 less than if their clients had been eligible for private insurance instead! That has a direct impact on the number and diversity of organizations that can sign on to be Navigators and help people in their communities. One thing legislators have done to honor the good work of Navigators is implement screening processes that are comprehensive, but not excessive. Legislation was proposed mandating the fingerprinting of Navigators, treating them as entities consumers should be wary of. In other states legislation has been proposed to bar navigators from setting foot on County property. In reality, Navigators are a consumer’s best friend. Angie Stevens from Southside Community Health Services in Minneapolis articulates the consumer benefits of Navigators, saying:
It is important to have a neutral source of assistance for people to utilize to navigate the health insurance process. As a certified MNsure Navigator, I have the opportunity to serve the community as a neutral assistor. I help guide people through the process of gaining healthcare coverage. Many have shared how grateful they are to have this resource available to them at no cost. With every application, here at Southside Community Health Services, we are teaching people how to navigate the MNsure system and assisting them in gaining healthcare insurance coverage that is available to them.
Navigators are key in connecting people to the health insurance programs they’re eligible for and a big reason that the uninsured rate in Minnesota is at an all-time low. Navigators inform, advocate for, and celebrate with consumers, and I expect consumers will continue to need Navigators in the future. It is important Navigators are financially supported and are portrayed in the positive light they deserve to be. Thank you to Katelyn, Angie, and the thousands of other Navigators across the state doing the good, hard work of helping people get health insurance. Health care consumers look forward to the continued vitality of the Navigator program. You can find a Navigator here www.mnsure.org or by calling our office for help finding one near you (218)626-7354.
