Extra paperwork delays key ACA program in Ohio

‘Navigator’ groups have until Friday to submit new data

More than a dozen Ohio nonprofits have been awarded more than $3 million in federal grants to hire and train so-called “navigators” to help medically uninsured Ohioans sign up for health coverage on statewide insurance exchanges created by the Affordable Care Act.

But with less than a month to go before enrollment in exchanges begins on Oct. 1, the navigator program has yet to take flight in Ohio, which has nearly 1.5 million uninsured people.

Grant recipients say progress has been slowed by stiff demands for accountability from congressional Republicans who oppose the health care law, and by Ohio’s own recently adopted navigator standards that forced at least one potential navigator to drop out.

Children’s Hospital Medical Center in Cincinnati was selected to receive a navigator grant of $124,419 from the U.S. Department of Health and Human Services.

But House Bill 3, passed by the Ohio General Assembly and signed into law by Gov. John Kasich in July, excludes hospitals and other organizations that receive reimbursements from healthcare payers — such as Medicaid and Medicare — from acting as navigators.

“We’ve notified the Centers for Medicare and Medicaid Services (which administers the grants) that we would not be able to accept any of the funding because of this change to the Ohio law that occurred in July,” said Children’s spokesman Terry Loftus. “That’s our status. We are not going to be a navigator.”

The ACA requires all states to have community-based navigators to help consumers learn about their coverage options and apply for coverage and federal subsidies to help buy insurance on the exchanges — officially designated the Health Insurance Marketplace by the Health and Human Services Department.

The department has awarded $67 million in grants to hire 105 Navigators in 34 states, where the federal government will set up the health exchanges.

In Ohio, the largest grant went to the Ohio Association of Foodbanks and a consortium of 14 other non-profits that will share $1,958,961 to fund their education and outreach efforts in all 88 counties.

But the group has yet to hire one navigator, and Foodbank officials blame Republicans on the House Energy and Commerce Committee for the delay.

Late last month, the House committee sent letters to 51 groups in 11 states that have received navigator grants, demanding all documentation and communications related to their grants and probing whether navigators have been properly trained to protect patient privacy, among other questions.

The Obama administration and Health and Human Services Secretary Kathleen Sebelius have decried the oversight committee’s actions as obstructionist.

The committee’s Republican spokeswoman, Noelle Clemente, told Reuters on Monday that the panel has had “positive and productive conversations” with navigators and expects to continue to do so.

The letter, signed by 15 Republican lawmakers, gives the navigators until Friday to submit answers and documents.

“The letter has had a very chilling affect, and it has diverted us from getting the navigator grant operational,” said Lisa Hamler-Fugitt, the Foodbank’s executive director. “With the large amount of information that they have requested, no work has moved forward.”

Hamler-Fugitt said scrutiny of the navigator grants has been more intense than any other federally funded education and outreach program the Foodbank has conducted during her tenure.

“Our work as navigators is no different than our work under the Medicare Modernization Act of 2003 that created the Medicare prescription drug benefit,” she said. “We ran a 79 -county program to reach out to seniors who were making choices between food and life-sustaining medication, and it had huge support from members of the Ohio Congressional delegation.”

Officials at Helping Hands Community Outreach Center in Dayton said they had just completed their response to the Congressional committee’s oversight letter, but they said they would not wait to hear how their answers were received before moving ahead with their plans for the $230,920 navigator grant they were awarded.

“We’re moving forward regardless of them giving us a green light or not,” said Neldra Glasper, the agency’s executive director. “We’re the only organization in Montgomery County that received a navigator grant, and we can’t wait to get the word out and make people aware in the community that insurance will be available to them under the Affordable Care Act as of Oct. 1.”

Glasper said Helping Hands has already hired two navigators who will be sent out with laptop computers in the next few days to local libraries and community centers to help people understand their coverage options and sign up for insurance on Ohio’s exchange.

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