Companies within the State of Missouri are receiving grant money to help residents understand how to sign up for the various programs becoming available under the Affordable Care Act.
The program is part of grants funded through Health and Human Services (HHS) that are being sent to private contractors throughout the United States to aid in the implementation of the new healthcare system.
HHS Secretary Kathleen Sebelius recently announced $67 million in grant awards to 105 Navigator grant applicants in Federally-facilitated and State Partnership Marketplaces. These Navigator grantees and their staff will serve as an in-person resource for Americans who want additional assistance in shopping for and enrolling in plans in the Health Insurance Marketplace beginning this fall.
HHS recognized more than 100 national organizations and businesses which have volunteered to help Americans learn about the health care coverage available in the Marketplace.
"Navigators will be among the many resources available to help consumers understand their coverage options in the Marketplace," said Sebelius. "A network of volunteers on the ground in every state -- health care providers, business leaders, faith leaders, community groups, advocates, and local elected officials -- can help spread the word and encourage their neighbors to get enrolled."
Health care quality-improvement consulting firm Primaris is one of the companies awarded more than $1 million in grant funding to serve as an in-person resource for Missourians who want additional assistance in shopping for and enrolling in plans in the Health Insurance Marketplace beginning this fall.
With the bill's primary initiative -- a coverage mandate that taxes individuals who do not enroll in coverage -- set to take effect on Jan. 1, 2014, residents are left a limited amount of time to find their choice of involvement without paying a penalty.
A long-enduring court battle has only served to make the window smaller with Missouri being one of the states that has refused to come into compliance by setting up a healthcare exchange for residents.
As a federal Navigator, Primaris will lead a coalition of 11 community partners around the state to provide unbiased, free assistance to Missourians eligible for the new Federally-facilitated Marketplace. Qualified health-insurance plans will offer coverage to eligible Missourians beginning Oct. 1.
Trained, certified navigators will help uninsured Missourians -- many of whom have limited English speaking skills or other disadvantages -- find the best plans for their health needs and family budgets.
Consumers can learn about and enroll in coverage later this fall through HealthCare.gov. HHS launched a 24-hour-a-day consumer call center ready to answer questions in 150 languages. More than 1,200 community health centers across the country are preparing to help enroll uninsured Americans in coverage, and a partnership with the Institute of Museum and Library Services will help trusted local libraries be a resource for consumers who want information on their options. In addition, HHS has begun training other individuals who will be providing in-person assistance, such as agents and brokers and certified application counselors.
Navigators are trained to provide unbiased information in a culturally competent manner to consumers about health insurance, the new Health Insurance Marketplaces, qualified health plans, and public programs including Medicaid and the Children's Health Insurance Program. The Navigator funding opportunity announcement was open to eligible private and public groups and people who are self-employed who met certain standards to promote effectiveness, diversity, and program integrity.
Navigators will be required to adhere to strict security and privacy standards -- including how to safeguard a consumer's personal information. They'll be required to complete 20-30 hours of training to be certified, will take additional training throughout the year, and will renew their certification yearly. All types of enrollment assisters -- including in-person assisters, Certified Application Counselors, and agents and brokers -- are required to complete specific training and are subject to federal criminal penalties for violations of privacy or fraud statutes, on top of any relevant state law penalties.
Missouri is one of 19 states that ceded control of its Affordable Care Act exchange to the federal government. Fifteen states are teaming with the federal government, while 16 states and the District of Columbia are building their own exchanges.
The Associated Press reported last week that Missouri has approximately 877,000 uninsured residents -- a gap the Affordable Care Act was designed to fill.
In the meantime, residents are left to wonder how to get involved in the program and even whether they will have to, given Missouri's staunch objection to the program.
As a whole, everyone will either participate or suffer a penalty at income tax time.
Another way to find out what will be asked of the public from the program is to visit a new website launched by the Missouri Hospital Association (MHA.)
Enroll Missouri, located at http://enrollmissouri.org, is active and aims to increase public understanding of the various programs, the exchanges and what will be required of them based on factors such as income level and family size.
The new rules guarantee access to individual coverage regardless of current or past health problems, require each plan to cover at least 60 percent of costs and limit annual out-of-pocket costs such as co-payments and deductibles. New rules limit the amount that older plan members may be charged. There are more requirements established by the lengthy document.
For more information, contact Primaris at http://primaris.org, Enroll Missouri at http://enrollmissouri.org or visit healthcare.gov to find out what the coming changes will mean to you and your family.