Trump cuts to Obamacare lead to hustle by Chicago nonprofits, hospitals – Health Care News

on Jul27

27 July 2017 | 10:30 am

CORRECTED

Community groups are scrambling to figure out how to connect Chicagoans with health insurance in the wake of the Trump administration no longer funding outreach efforts in 18 cities, including Chicago. The federal money was used to help enroll people into plans sold on the Obamacare public health insurance exchanges, and to usher the uninsured into the expanded Medicaid program in Illinois.

Combined with consumer confusion over how lawmakers in D.C. aim to potentially unravel the Affordable Care Act, and a shorter enrollment period on the exchanges, experts fear people won’t sign up, effectively killing the online marketplace. A drop in enrollees, especially among young adults whom insurers need to balance out the costs of their sick and expensive enrollees, could cause carriers to pull out of the marketplace. That would, in turn, give Republicans the political ammunition they need to argue that the ACA, also known as Obamacare, should be repealed.

“The funding cut, in addition to the confusion that is out there right now, is going to dampen enrollment. I’m very concerned about that,” said Stephani Becker, a Chicago-based senior policy analyst at the Sargent Shriver National Center on Poverty Law. “Data has shown the past couple of years that those who had help were almost twice as likely to enroll. We need more boots on the ground, not fewer.”

The cuts will disproportionately affect African-American and Hispanic communities, Becker said, since the federal grants supported storefronts and enrollment efforts in underserved communities.

Complicating the problem, many Illinois hospitals and agencies no longer have the funds to fill the gap. An earlier wave of federal cuts damaged some safety net hospitals’ outreach. Norwegian American Hospital and Sinai Health System, which both treat a large portion of low-income patients, each lost navigator funding in 2015, spokespeople from the organizations said. Before then, Sinai received about $750,000 per year in navigator funds. That helped hire about 20 counselors who helped some 15,000 patients sign up or learn about their insurance options, said Myra Nash-Johnson, system director of integrative care at Sinai.

“Communities serviced included some of the most impoverished and high-crime neighborhoods of the city,” Nash-Johnson said.

STATE MUM ON PLAN FORWARD

Get Covered Illinois is the state health insurance exchange born out of Obamacare. It launched in 2013 with the goal of creating a competitive marketplace where consumers and small businesses could shop for health insurance. Illinois is among more than three dozen states that route consumers and small businesses to the federal platform, HealthCare.gov, to buy health plans. Those who fall below certain income levels can use federal subsidies to pay for coverage. In 2017, open enrollment runs from Nov. 1 to Dec. 15.

About 294,000 Illinoisans had health plans purchased through the federal marketplace at the end of March, and 640,000 have signed up for Medicaid under the ACA’s expansion of the program, according to the most recent federal data available.

Originally, Get Covered Illinois employed counselors and educators who helped educate people about their options. Then two years ago, much of the program’s funding was cut and many staff positions eliminated. Now it’s not clear what the state of Illinois’ efforts are, if any, to help people enroll for health insurance. The Tribune reported earlier this month that the Department of Insurance, which has operated Get Covered Illinois since 2015, had laid off 15 of the program’s employees, but a few administrators and some call center and IT staff remained.

A spokesman from the Illinois Department of Insurance declined to comment on how it planned to educate residents about their health care options and would not provide specific numbers of how many people are currently staffed at Get Covered Illinois.

Gov. Bruce Rauner has been silent, too, about how Illinoisans should get help signing up or learning about their insurance options. A spokesperson from his office supplied Crain’s a June statement that said he is “closely engaged” about changes to Medicaid and the ACA.

The federal cuts announced last week are the latest in a series. Last week, the Centers for Medicare & Medicaid Services, which oversees HealthCare.gov, announced that at least one company that was active in Illinois will no longer help with enrollment. Falls Church, Va.-based CSRA operated an Albany Park storefront where community members could get health care assistance. In total, the number of “navigator grants” distributed in Illinois to help people enroll in Obamacare plans dropped to six in 2016, down from 11 in 2013. Only two organizations—United Way and Patient Innovation Center—now receive federal funding to help Cook County consumers.

United Way of Metro Chicago takes appointments through a website so people can get general answers related to health care. Since 2013, the organization has helped 22,771 people get health plans, said Inna Rubin, manager of health access initiatives for the nonprofit. The group will continue its work since “there is a great deal of confusion around healthcare and enrollment,” Rubin says.

Other groups are footing the bill for their outreach efforts.

“I’m happy that (Rauner) hasn’t spoken against the ACA, against expanded Medicaid, but I would always want my officials to speak out,” said Dr. Santina Wheat, medical director at Erie Family Health Care in Humboldt Park. “I’m sad whenever funding is cut to help people get insurance. Expanded Medicaid has been such a wonderful program, multiple patients feel like it has saved their life.” Erie Family Health Care employs 36 enrollment access specialists, many fluent in Spanish and English, who help patients sign up for Obamacare plans.

The Cook County Health & Hospitals System also underwrites its own efforts to educate and enroll patients, whether through Medicaid or a plan purchased through the marketplace, said Dr. Jay Shannon, CEO of Cook County Health.

“One-third of our patients remain uninsured,” Shannon said in a statement. “As efforts to repeal the ACA persist, we must protect the significant improvements the legislation has created in expanding access to health insurance.”

This story has been updated to correct the fact that United Way of Metro Chicago does not operate an Office of Consumer Health Information.



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