Ahead Of Uncertainty-Filled Enrollment Period, Government Pulls Funds For Sign-Up Assistance

Jul 28, 2017

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The Centers for Medicare and Medicaid Services, or CMS, has announced it won’t be renewing contracts with companies providing enrollment assistance for people shopping for health insurance on the Federal Exchange this year, including a location in Indianapolis.

The announcement came around the same time President Donald Trump’ stated  he wanted the government to “let Obamacare fail,” suggesting this may be a step in that direction. But CMS officials say the enrollment assistance contracts were put in place to help familiarize the public with healthcare.gov while it got off the ground and were thus always meant to be temporary.

The federal government began funding the Open Enrollment Assistance programs in more than a dozen cities in 2013, paying two Virginia-based companies to open storefronts to help people sign up for marketplace insurance.

Indianapolis’ program was stationed on the north side, but also used community outreach efforts to direct people to healthcare.gov’s plans, particularly young and healthy enrollees, says Covering Kids and Families’ Policy Director Mark Fairchild.

“Their reach was unique,” he says. “Their largest focus was really metropolitan areas, especially those "young invincibles," those folks we knew weren’t otherwise approaching the market who weren’t really sure if they had an insurance need.”

Experts say the program was only responsible for an average of 1 to 2 percent of all direct marketplace enrollments nationally, and its reach was tapering off. According to CMS, in 2017’s period, the programs only accounted for 15 ,000 direct enrollments nation-wide during 2017.  

“Now that we’ve had the marketplace for a number of years, we’re past that initial confusion and functionality problems,” Fairchild says. Still, he says, the tumultuous health insurance market, combined with this year’s shortened 45-day enrollment window means people might need more assistance than ever.

“We’ve got a shorter enrollment window.  We’ve got a lot of confusion, we've got consumers that are very used to having things taken away from them, including things like healthcare coverage,” he says.  

Thanks to news coverage about GOP efforts to repeal and replace Obamacare, many people think the Affordable Care Act has been dismantled, he says: “Altogether, we’re really hoping that doesn’t take us back to where we were.”

Assistance for marketplace enrollment is always going to be needed for new people coming in each open enrollment period, says Julia Holloway, a health navigator at Affiliated Service Providers of Indiana, a nonprofit health education organization. For example, people coming off their parents’ insurance when they reach 26 or people who have recently lost their job could be seeking insurance on the marketplace for the first time.

“Since we heard the news about the contract we have been thinking about how we will pick up the slack,” says Holloway. "We can’t touch everybody. We know this year it’s going to be a really tight time. Because of the six weeks, we’re going to need everybody possible.”

A CMS spokeswoman wrote in an email the agency will “have the on-the-ground resources necessary in key Exchange markets.”

The contracts officially will end at the end of August. Open enrollment for 2018 starts November 1st.

Help is still available through both healthcare.gov and through organizations such as the Affiliated Service Providers of Indiana and Shalom Health Care Center.

This story was produced by Side Effects Public Media, a news collaborative covering public health.