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Health navigators’ work won’t end with Obamacare deadline

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Updated: April 24, 2014 6:28AM



There’s plenty of attention focused on March 31, the last day people can buy health insurance under the Affordable Care Act to receive coverage this year and avoid a tax penalty for not having insurance.

But for many “navigators,” who are paid by the state or federal government to help people get insurance through the ACA, their job doesn’t end with that deadline. People who qualify for Medicaid, the state-federal program for low-income people, can enroll any time without penalty, and navigators will continue their role.

Anyone who has a “qualifying event,” such as a marriage, birth of a child or loss of a job, also can enroll without facing a fine anytime after March 31, the law states.

Medicaid enrollees must be between 19 and 64 years old, make less than roughly $15,860, be a U.S. citizen or must have been a legal immigrant for at least 5 years.

Though Illinois law was changed to expand who could qualify for Medicaid, which has little or no cost for most services, people still must apply to get the insurance. Of the more than 1.6 million uninsured Illinoisans, the state estimates about 342,000 will enroll in Medicaid by 2017.

Many navigators, or in-person counselors as they also are known, said funding for their jobs from either the state or federal government ends on June 30.

“While [health care] marketplace enrollment will end March 31, navigators will still be able to enroll [residents] in eligible Medicaid programs, and we will still be actively doing Medicaid enrollment based on the patient base we serve,” said Elaine Hegwood Bowen, a spokeswoman for Access Community Health Network, which has Chicago locations.

Mike Claffey, a spokesman for the state-run Get Covered Illinois, said, “We are expecting federal funding for year two, but we don’t have any details on how much it will be.”

“We certainly anticipate the need for navigators” beyond the end of the month, Claffey said, in part for uninsured people who have never had health insurance before and may not be familiar with how it works.

Yang Sun, an in-person counselor at the Midwest Asian Health Association in Chinatown, estimates that on a typical day she gets three to four appointments from people signing up to get health insurance. But another five to six people are walk-ins who have enrolled in a plan through Obamacare, yet have questions about it, like how a deductible works, Sun said.

In addition to helping enrollees understand their new coverage, navigators say they are assisting people by rounding up the documentation required to sign up for health insurance, clearing up misinformation and working to get immigrants to enroll.

“I foresee progress on all of these fronts, and our navigators are incredibly optimistic, but it will take time, and this work will extend far beyond [March 31],” said Dominique Williams, program officer with LISC Chicago, which gave grant money to 21 organizations for navigators.

Email: mjthomas@suntimes.com

Twitter: @MonifaThomas1



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