For insurance exchanges, states need ‘navigators’ — and hiring them is a huge task
By N.C. Aizenman,
Signing up an estimated 30 million uninsured Americans for coverage under the health-care law is shaping up to be, if not a bureaucratic nightmare, at the very least a daunting task.While some people will find registering for health insurance as easy as booking a flight online, vast numbers who are confused by the myriad choices will need to sit down with someone who can walk them through the process.
Enter the “navigators,” an enormous new workforce of helpers required under the law. In large measure, the success of the law and its overriding aim of making sure that virtually all Americans have health insurance depends on these people. But the challenge of hiring and paying for a new class of workers is immense and is one of the most pressing issues as the Obama administration and state governments implement the law.
Tens of thousands of workers will be needed — California alone plans to certify 21,000 helpers — with the tab likely to run in the hundreds of millions of dollars.
“I would say the task we face is herculean,” said Denise de Percin, executive director of the Colorado Consumer Health Initiative, an advocacy group that has studied what it will take to staff her state’s navigator program.
Over the short term, some workers may be funded by federal grants, state budgets or private money. But over the longer term, most of the costs are to be covered by the new health-care marketplaces, called “exchanges,” being set up in every state. The money will come from fees that insurers will pay to sell their plans on the exchanges.
Groups such as unions, chambers of commerce, health clinics, immigrant-service organizations, and community- or consumer-focused nonprofits can use the grants to train and employ staff members or volunteers to provide in-person guidance — especially to hard-to-reach populations — and to provide space for them to work.
Added to the logistical challenge is a political one: Insurance brokers in many states are lobbying to prohibit the navigators from giving advice on which plans to choose and to make them liable for their guidance if it results in financial harm.
The brokers, who earn commissions and fees by enrolling people in plans and who might lose business to the navigators, contend that the navigators won’t have sufficient expertise.
“What you don’t want is for our agents to be cut out and to have this force of untrained, unlicensed individuals giving advice with no financial responsibility,” said Ryan Young, head of government relations for the Independent Insurance Agents and Brokers of America, an industry trade group. “Consumers are going to get hammered.”
Under the law, the exchanges must fund enough navigators to ensure that every applicant who needs assistance can get it.
“You have to ask, how many people can one navigator help in one day?” de Percin said. “Well, the people who do this kind of work might spend an hour to three hours with folks. So the answer is not many.”
http://www.washingtonpost.com/national/health-science/for-insurance-exchanges-states-need-navigators--and-hiring-them-is-a-huge-task/2013/02/04/bb5e577c-6960-11e2-ada3-d86a4806d5ee_print.html
Maine AG wants hospitals to allow public into meetings
The boards of those that rely mostly on taxpayer funding should be more open to scrutiny, the attorney general says.
The past two Legislatures have reviewed – and defeated – proposals to make the board meetings of the state's hospitals subject to Maine's right-to-know law. This year the state's top lawyer is upping the ante with a bill that would require some hospitals that receive public funding to hold public meetings.
Attorney General Janet Mills said Monday that she's drafting legislation that would affect hospitals that receive 50 percent or more of their operating revenues from state and federal funding.
The measure would allow the public to attend board deliberations at those hospitals on issues such as capital expansion projects and purchases that could affect host communities and taxpayers.
Mills' bill, which has not yet been printed, arrives as state lawmakers and Gov. Paul LePage prepare for deliberations on the budget and the governor's proposal to pay $484 million in Medicaid and Medicare reimbursements owed to hospitals by the state.
The debt payoff plan is politically charged. Democratic lawmakers agree that the state should reimburse the hospitals, but they are uneasy about the governor's apparent coziness with the Maine Hospital Association, the influential organization representing the state's 39 hospitals, 34 of which are nonprofits.
Mills, a Democrat, said Monday that her proposal isn't politically motivated. She said hospitals that receive significant public funding should conduct business that affects their host communities in the light of day.
Public school workers’ health plan teams with wellness company
Posted Feb. 04, 2013, at 4:36 p.m.
More than 50,000 Maine public school employees and their family members can tap into wellness programs under a new partnership between their health plan and a Tennessee company.
The Maine Education Association Benefits Trust, a not-for-profit benefit plan that administers health insurance coverage for most of Maine’s public school employees, has teamed up with Onlife Health Inc., a Brentwood, Tenn.-based wellness company, to serve 54,000 public school employees in Maine and their dependents.
The partnership will make Onlife’s wellness services, including health coaches and online courses, available to employees at 600 schools across the state. Active and retired employees, teachers, administrators, food service staff and other personnel covered by the trust’s Anthem Blue Cross and Blue Shield health insurance plan will be eligible.
The trust is a separate but sister organization to the Maine Education Association teachers union. The health plan serves both union and non-union public school employees.
The trust hopes that the new wellness program will help employees to better understand their role in rising health care costs, said Christine Burke, executive director of Maine Education Association Benefits Trust. Preventing employees from getting sicker as they age and heading off illnesses related to smoking, inactivity, obesity and other risk factors will benefit both the plan’s members and its future bottom line, she said.
“We’re really trying to avoid that slow climb toward illness,” Burke said.
Health committee’s opposition to LePage cuts would add $7.6M to budget By Matthew Stone, BDN Staff
Posted Feb. 01, 2013, at 3:36 p.m.
AUGUSTA, Maine — The legislative committee that oversees Maine’s health and human services programs Friday came out against cuts to child adoption subsidies, prescription drug aid for seniors, rural hospital reimbursement rates, substance abuse treatment and other reductions proposed by Gov. Paul LePage to fill a $112 million hole in the current year’s budget.
And while the Legislature’s Health and Human Services Committee also opposed a handful of new spending initiatives in LePage’s budget proposal, the committee’s actions would add about $7.6 million to the budget gap if they’re allowed to stand, according to the Legislature’s Office of Fiscal and Program Review. LePage is proposing the supplemental budget to account for flagging tax revenue collections and cost overruns in the state’s Medicaid program.
The Health and Human Services Committee on Friday shared its recommendations with the budget-writing Appropriations Committee, which will soon have to recommend a final budget proposal to the full Legislature.
Most of the Health and Human Services Committee’s recommendations against LePage’s proposed cuts were the result of party-line votes in which majority Democrats opposed the reductions and the panel’s Republican members voted to support them.
Maine’s insurance reform is working — now repeal it?
Posted Feb. 04, 2013, at 2:05 p.m.
Maine’s health insurance reform law, or PL 90, enacted in the last legislative session, is working. For the first time in decades there is positive news for Maine’s health insurance consumers — yet some want to gut the bill and render it impotent.
After a decade of double-digit increases, the recent rate increase by Anthem for the individual health insurance market was only 1.7 percent — the lowest increase ever and despite the fact that medical cost inflation is around 8 percent. New products are also available for some individuals at even lower rates.
According to the most recent data from the Maine Bureau of Insurance, Maine’s group insurance market is also improving. In the fourth quarter of 2012, 17 percent of Maine businesses saw lower rates. Also, more businesses are seeing smaller increases. At first, these positive statistics were mostly found on the southern half of the state but the most recent data show that all sections of Maine are beginning to see the benefits.
These positive new trends are not because of any “bold” experiments or dramatic mandates but are the result of common sense reforms that have been successful all around the country. With the advent of PL 90, Maine health insurance markets are moving back toward normalcy.
Democrats, however, who campaigned vigorously against the new insurance reform law last fall, have made overhaul of the law one of their legislative priorities and have submitted a number of bills to effectively hobble PL 90 despite its successes.
They’ve nicknamed PL 90 the “rate hike bill” even though rates are stabilizing and have indeed dropped for many. They’ve said insurance companies can now raise rates without approval, which is false — all rates will continue to need approval and all with the same standards as before.
They issued phony reports that cherry-picked data and ignored positive new trends (see Consumers for Affordable Health Care). They have said there are fewer product choices even though the opposite is true. And they have completely ignored the many negative effects of ObamaCare.
Democrats and other “single payer” advocates don’t want to see the health care/health insurance dilemma solved through the free market. They believe the only real solution is through stricter regulations, greater subsidies and, ultimately, more government control — all of which have been tried and tried again over the past two decades and all of which failed.
According to the insurance bureau, Mainers have endured average yearly rate increases of 19 percent in the small group market for the 10 years preceding PL 90. For individuals, the average increase was 13 percent.
Many saw increases much higher than that.
These crushing rate hikes were the result of an onslaught of left-wing health care and health insurance experiments over the past two decades.
Ohio GOP Gov To Accept ObamacareMedicaid Expansion
Ohio Gov. John Kasich (R) announced on Monday that he would accept an Obamacare provision to expand the Medicaid program in his state, becoming the fifth GOP governor to do so, the Cleveland Plain Dealer reports. Kasich added that he would reverse his decision should the federal government fail to cover the full cost of the expansion, as provided in the law.
"Obamacare is the law of the land for now and Ohio needs work to reduce its impact," Kasich said, according to the Plain Dealer.
The Supreme Court ruled last year that states could choose to opt-out of the Medicaid expansion under President Obama's Affordable Care Act, known as "Obamacare."
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