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Austin health insurance group’s federal funds cut

Thursday, September 21, 2017 by Jo Clifton

In Washington, D.C., supporters of repealing the Affordable Care Act, known as Obamacare, are putting pressure on a few Republican senators who may or may not go along with that legislation. The Senate has until Sept. 30 to pass the legislation or they will have to start all over.

And in Austin, two organizations are gearing up for the shortened period for signing up people who need health insurance and also need help sorting through the various options.

Data from the U.S. Census Bureau indicates that 87 percent of Austin’s civilian population is insured. However, that number falls to 76.5 percent for people identified as Hispanic or Latino according to the 2016 American Community Survey.

Foundation Communities and the Latino HealthCare Forum both help people who need assistance with the often tricky process of picking an insurance provider, but only one of them has received federal money to do the job.

Walter Moreau, executive director of Foundation Communities, told the Austin Monitor that his organization does not receive any federal funding for navigators. Instead, the group receives money from Central Health, the Saint David’s Foundation, the city of Austin and one of the Seton Healthcare foundations to help people understand and pick a health insurance plan.

Jill Ramirez, CEO of the Latino HealthCare Forum, reported that her group received about $240,000 per year for 2015 and 2016 to provide outreach and navigators to help people sift through the various health insurance options.

Last week, the Health and Human Services Department informed administrators of such groups across the country that their funding would be slashed by as much as 92 percent.

According to a Washington Post story, “Texas will get about $6,111,000 for ACA outreach this year. That’s 35 percent less than last year.” However, the cuts are clearly not equal across groups.

The Latino HealthCare Forum received notice that they would be offered just $13,000 this year, about 5 percent of what they have received in the two previous years, according to Ramirez.

Linda Smith, who is the group’s Chief Administrative Officer, told the Austin Monitor via email that the sudden withdrawal of most of the group’s funding was “totally unexpected and disruptive.”

Smith and Ramirez said they worked through the summer to make sure that their health insurance navigators had updated their certifications before Sept. 1, as the federal guidelines instructed them to do. “Then on the day the contract was to be effective, we were noticed to put everything on hold,” Smith said.

They received a notice late last week that they would only get $13,000 and they must decide before the end of the month whether to accept the money and the strings that are tied to it.

Smith said she isn’t sure yet whether the organization will accept such a small amount because by accepting the money they will also have to accept federal goals. It’s like being “set up to fail,” she said.

We “can’t pay 12 navigators with $13K to enroll for six weeks,” Smith wrote. The enrollment program runs from Nov. 1 through Dec. 15, half of the time period allotted for previous sign-ups.

Last week, as they put the finishing touches on their Fiscal Year 2017-18 budget, City Council members added $250,000 to assist both the Latino HealthCare Forum and Foundation Communities with their navigator programs. Council left the decision about how much money to give each organization to staff of Austin Public Health.

Austin Public Health spokesperson Carole Barasch told the Monitor on Tuesday that both organizations received $200,000 from the city last year, but no decision has been made about how the funds will be distributed this year.

When informed this week about the drastic cut to funds for the navigator program at the Latino HealthCare Forum, Council Member Pio Renteria said, “My biggest fear is that there’s going to be a lot more of those kinds of cuts.” Renteria was one of those leading the charge during last week’s budget deliberations to put an additional $50,000 into the navigator program.

“I was on the Community Development Commission when (President George W. Bush) cut 20 percent from the community development block grants. We lost so much money that the city had to come in and rescue the housing department,” he said.

Mayor Steve Adler said, “Some of the best investments we can make in our local health as well as our economy is to register eligible people for the Affordable Care Act. Not only does it get services for people who need them, it’s like a nine-to-one dollar leverage for us. So when the federal government cuts money to help people, it hurts us two ways. I think that’s one of the reasons why the City Council as part of its budget included some funding for ACA registration.”

According to Moreau, Foundation Communities provides help for people trying to sort out their medical bills as well as finding the right provider network and how to use insurance.

Foundation Communities’ Insure Central Texas has two locations, one at 5900 Airport Blvd. across from the Austin Community College campus and a second at 2600 W. Stassney Lane, near Stassney and West Gate Boulevard.

Elizabeth Colvin, the director of Insure Central Texas, told the Monitor that since 2013, her organization has enrolled 22,800 people in health care coverage. Some of those were duplicates, she said, but not many.

The Latino HealthCare Forum also helps people become familiar with options for insurance and helps them sort through their medical bills, but the Latino HealthCare Forum, located in Southeast Austin at 6601 Felix Ave., concentrates on serving the east side of the city.

Both organizations offer people help not only with the Affordable Care Act but also with signing up with other programs, such as Medicaid, Medicare, the Medical Access Program and the Children’s Health Insurance Program. “We have the concept of no wrong door,” said Ramirez. Colvin told the Monitor the same thing about Insure Central Texas.

According to data from the Latino HealthCare Forum, although the organization held hundreds of events to reach out to the community to explain insurance options, and their attendance numbers have been high, the group’s total Obamacare enrollment for the past year was only 217. This probably helps explain why the federal funding has been cut so drastically.

A number of groups nationwide have pointed out that the Health and Human Services Department seemed to not understand how important it was to get out the word about the availability of insurance.

Many of the people who did not enroll may have gotten insurance through some other program, such as Medicaid.

Ramirez said, “We do enrollment, but the ACA was a campaign. Most of what really counts is the campaign and that is what we worked on really hard (in the past).” Sometime this summer, Ramirez was told not to worry about doing outreach, and she said it seems to her that the federal agency has not given her group any credit for all the outreach that they have done, which includes hundreds of events with thousands of people.

Ramirez said the organization will receive $50,000 this year from the St. David’s Foundation for navigators to help residents of Williamson, Bastrop, Caldwell and Hays counties only.

As to whether they will take any federal money this year, Ramirez said, “We have to look at how much work it is for $13,000,” noting that meeting the program’s requirements “might outweigh the benefits. We have to make a decision. We want to continue to do the work we do (but) we’re like in limbo. We should be getting some money from the city and funding from St. David’s, so we will continue despite,” the federal cut.

Insure Central Texas, the Foundation Communities program, is urging people to make appointments at one of their locations during the month of October. People who do that will find that they can get the information and think about it, make a decision and then come back in November and signing up will be much easier, Colvin said. The Airport Boulevard location will be open seven days a week and the south location will be open every day except Sunday, she said.

Central Health is also providing funding for United Way, which provides assistance for people seeking health insurance. In order to use its services, people can call 211 and get information.

This story has been corrected. We originally reported that Linda Smith is the treasurer of Latino HealthCare Forum. She is the Chief Administrative Officer.

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