The importance of health care navigators to Texas
By Kathleen Sebelius
Dallas Morning News
December 15, 2013
Millions of Texans don’t have the security of health coverage. In fact, Texas has the highest rate of uninsured in the nation. Yet there are some who will seemingly stop at nothing to deter Texans — and those who assist them — from obtaining coverage or even learning about their new options under the Affordable Care Act.
What opponents of the new law could not do legislatively, at the ballot box, or even by shutting down the federal government, they’re now trying to do through other means. Case in point is Monday’s congressional hearing in Dallas, designed to stifle, intimidate and impugn the reputation of people who have been working hard to help their fellow Texans get covered.
Just who are these people working to assist their fellow Texans? Those I’ve met are dedicated, civic-minded Americans who have opened their hearts to their neighbors, because they want to help.
Navigators and other assisters work to educate people about their new options. They’re not paid to sell insurance. Rather, they work to help people understand what financial help is available, and to learn about their choices, so they can make good decisions for themselves and their families.
Navigators in Texas must complete at least 20 hours of training (including training on privacy protection and security), pass a rigorous exam, demonstrate they don’t have a conflict of interest, and participate in weekly training sessions.
Certified application counselors working at hospitals, community health centers and social service agencies must also go through rigorous training before they can provide assistance to consumers.
More than 19,000 trained assisters, counselors and navigators have worked with more than 450,000 Americans in their communities, to help them understand the options available under the new law.
Helping people obtain health coverage is not about politics, it’s about people. Millions are counting on finally being able to obtain affordable coverage. And in the first two months of a six-month open enrollment, 1.2 million Americans either selected a health plan or received an eligibility determination or assessment for Medicaid or the Children’s Health Insurance Program.
Now that HealthCare.gov is working smoothly for the vast majority of users, we expect more Americans to shop for plans and enroll in quality, affordable coverage.
In the first week of December alone, HealthCare.gov was visited 5 million times. In November and October, more than 5 million Americans dialed into the Marketplace call center (1-800-318-2596).
But many prefer to meet with someone face to face in their own community who can answer their questions and lend a helping hand. That’s where navigators and other trained assisters come in.
In Texas, their work is particularly important. Nearly one in four Texans is uninsured: 4.9 million in all, 1.1 million in the Dallas-Fort Worth area. And there are more uninsured children in Texas than in any other state.
Navigators and other assisters are working to help these folks get covered so they’ll no longer have to forgo cholesterol and cancer screenings, risk bankruptcy, or have to choose between putting food on the table and taking their kids to the doctor.Through the Marketplace, a Dallas family earning $50,000 per year can obtain affordable coverage for as little as $26 per month. And there is choice and competition that quite simply were not available to Texans before the Affordable Care Act. In North Texas alone, there are 43 qualified health plans offered on the Marketplace.
Many currently uninsured Texas families will be able, for the first time, to get some financial help paying their premiums, since they don’t have affordable coverage at work.
As more Texans get covered, it benefits everyone: Fewer people are forced to rely on the emergency room for care (which raises costs across the board), and the Texas economy benefits from a healthier workforce.
Texas could benefit even further if the state expanded Medicaid, and with it access to coverage for 2.5 million people, many of whom work in jobs which either don’t offer insurance or don’t pay enough to make it attainable.
With so many Texans lacking affordable coverage, now is not the time to be putting up roadblocks. We should be helping navigators and other assisters in their important work, not demonizing, demoralizing or deterring them.
Kathleen Sebelius is the U.S. secretary of health and human services. She wrote this column exclusively for The Dallas Morning News.