February 5, 2023

A health navigator helps people enroll in Obamacare plans in Dallas in 2017.  That year, federal funding for navigators was higher than it was under the Trump administration.  A record number of people signed up for plans.

A health navigator helps people enroll in Obamacare plans in Dallas in 2017. That year, federal funding for navigators was higher than it was under the Trump administration. A record number of people signed up for plans.

LM Otero/AP

Updated January 25, 2023 at 12:48 p.m. ET

Affordable Care Act health insurance markets just hit a record 16.3 million People have signed up for the insurance, also known as Obamacare.

That’s a million more people than enrolled in ACA health insurance last year. (Registration is closed on Healthcare.gov but is open through January 31 on state marketplaces in California, Washington, DC, New Jersey, New York and Rhode Island.)

“Enrollments at Healthcare.gov are up a whopping 50% since President Biden took office,” Ambassador Susan Rice, the president’s domestic policy adviser, told reporters Wednesday. Among those enrolled were 3.6 million people who were new to the market, she added, people who “will now have the peace of mind that health insurance brings.”

What is driving the uptrend? The main reason is that the plans are cheaper for people than they used to be. The federal government has pumped billions of dollars into subsidies in recent years to keep costs down for consumers.

According to health officials, 4 out of 5 enrollers qualify for plans that cost $10 or less per month. And 5 million people who are uninsured qualify for zero-dollar premium plans, according to a recent analysis by the Kaiser Family Foundation.

Another reason more people are probably signing up is because there is more logistical help. The Affordable Care Act created a program of “navigators” — people across the country who are trained to help consumers understand their options and enroll in a health plan. It is a service paid for by government grants.

The Trump administration has cut funding for this program. The Biden administration backed it. Katie Roders Turner is Executive Director of the Family Healthcare Foundation. Her organization is part of the Tampa Bay Navigator Project in Florida, which has grown from 16 to 35 Navigators this year – more than doubling the number of employees.

“We’ve really made progress this year,” says Roders Turner. “We were really able to spread the need and demand among these navigators.”

Tears of joy in Central Florida

One of the people her organization has helped over the past few weeks was Erin Dimmig. She and her husband Tyler are 30 years old and live in Plant City, Florida. At the moment she describes herself as “very pregnant” – she is expecting her first child in February.

That fall, “my husband got a new job offer and it put him on a 90-day insurance gap, and we were due in 60 days,” she explains. They couldn’t afford to keep paying for the insurance they had from his old job — COBRA would cost them $1,600 a month.

She says she had no idea where to start looking for alternatives. She googled Healthcare.gov, the federal marketplace used by Florida and 32 other states. (State websites can also be accessed at Healthcare.gov).

She began answering questions such as household size, income, and other details. “Once you clicked the ‘You are pregnant’ button, there were all sorts of confusing questions and I was absolutely overwhelmed,” she says.

She clicked on the directory to find navigators in her area and found a local community center on the list. Soon after, the Dimmigs sought out navigator Jorge Masson.

“We went through the whole process with Jorge. He helped us choose a plan that worked for us. In the end, it turned out to be better to split our insurance,” she says. “It’ll end up saving us about $9,000 on childbirth and all that. I cried when we found out we were going to save a lot of money.”

Toggle to handle enrollment in Medicaid

Biden administration health officials don’t have much time to celebrate the success of open enrollment as a major challenge looms: How to prevent millions from becoming uninsured as the Medicaid pandemic ebbs.

After the 2020 COVID-19 public health emergency declaration, states were not allowed to require people to fill out forms to confirm they were still eligible. As a result, new people signed up, but no one signed up, and the program grew. About 90.9 million people now have Medicaid, or CHIP, the children’s health insurance program.

From April, states can start “re-determining” again. More than 15 million people could lose Medicaid during the process, according to an estimate from the Department of Health and Human Services released this summer. The analysis suggests that nearly half of those who lose insurance coverage will do so because of administrative issues – such as

The agency in charge of Medicaid and the insurance markets — the Center for Medicare and Medicaid Services — is working feverishly to ease this transition and limit the number of people who remain uninsured.

When open enrollment comes to an end, some Navigators who have been brought in to provide support will return to other roles at their community organizations, but federal health officials are hoping the support system will remain in place to help people who will be opted out of Medicaid in the spring.

“Last year we raised additional Navigator funding — $12 million — to be exercised when resolution occurs,” said Ellen Montz, associate administrator and director of the Center for Consumer Information and Insurance Oversight at CMS , told reporters on Wednesday. This funding “came at a time that is allowing navigator organizations to keep their staff out of open enrollment and moving into the settlement process.”

Roders Turner in central Florida says its navigators are ready to help people when the April 1 settlement begins.

“We have an amazing group of people who are willing to be the workforce to help process Medicaid — identifying options for people getting off Medicaid or helping them complete the applications that are required to maintain their insurance coverage. She says, “We’re definitely prepared — and we know we’ll be needed — when Medicaid is wound up.”

Note: This story originally aired and was published on January 13th. It was updated on January 25th.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Leave a Reply

Your email address will not be published. Required fields are marked *