Wednesday, February 6, 2013

Obamacare Logjam

Let's say you have a new give away and need to sign up 30 million folks in 90 days. What do you do?

In the case of Obamacare, you plan to hire "navigators" to assist in the process. These navigators are kind of like online Wal-Mart greeters whose job is to direct you to the right health insurance plan.
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.

California is broke, as are several other states. Where will they get the money to pay for these navigators?
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.
That is a rather diverse group that is expected to become versed in the business of health insurance terms, plans and procedures. So if you need landscaping work, a green card and health insurance you can get it all at one place . . .
Compounding the difficulty, de Percin said, is that many of the uninsured struggle with English or don’t have easy access to the Internet. Others aren’t familiar with concepts like co-payments and deductibles, let alone the subsidies that will be provided for lower-income people or the new eligibility rules for Medicaid.
And the folks that wrote this law never considered any of this . . .
In a kind of Catch-22, the money must come from an exchange’s operating funds, which will rely on fees from insurers. But those won’t be available until at least Jan. 1, well after navigators must be in position.
States can pitch in during the meantime. But that’s an unlikely option in Colorado, which has stringent rules governing its budget.
Buy now, pay later. Hire someone that knew how to ask if you want fries with that order and make them navigators.
What could possibly go wrong?

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