Health exchange 'navigators' to help people find insurance

First, Mohamed Abu helped a family of five get their health insurance back. Then, after 30 minutes on the phone, he found out why a 60-year-old Somali woman with diabetes was denied health coverage. By the time he hung up, he'd arranged for her insurance to start Aug. 1.

All that was before 10:30 in the morning.

Abu, a patient support specialist for People's Center Health Services, hopes to do even more starting in October, when his clients will be faced with the complexities of the health insurance exchange system established by the Affordable Care Act. In essence, he'll be their navigator.

On Oct. 1, many states, including Minnesota, will launch the exchanges that will allow 48 million uninsured Americans to shop — electronically — for plans that will best suit their needs.

Like the travel websites Expedia and Priceline that help people plan their vacations, the health exchanges will provide information about cost and options, while also creating competition among private insurance companies.

What about those who don't have access to a computer? People who don't speak English as a first language? Or those who find the exchanges intimidating? Navigators like Abu are part of the bargain, under the rules of the ACA.

The federal government has set aside $54 million in grants to community and small-business organizations to provide education and unbiased information to individuals and small-business employers to help the uninsured population get through the health-exchange process.

Earlier this month, 16 Minnesota clinics received $1.6 million of that federal money to help more than 21,000 people across the state to enroll in health insurance plans. The grants ranged from $65,000 to $255,000 and were based on the number of uninsured patients each clinic serves.

Minnesota plans to invest $4 million in the program, as well. Through MNsure, it has asked clinics and other nonprofit groups to submit proposals for programs, staffing and outreach to the uninsured and others who need assistance. MNsure officials said that they have received 102 applications and that the winners should be announced no later than Aug. 23.

Participating organizations will be paid $25 for each enrollee who signs up for a public plan such as medical assistance and $70 for each one who enrolls in a commercial plan.

The job will require navigators to have expertise in eligibility and program specifics. They will receive additional training on how the exchanges work and for the education classes they will be required to teach.

In Minnesota, the training will be available online and will feature components that help navigators learn about the Affordable Care Act and how people will be able to apply for tax credits, among other topics. Training could start as early as mid-August.

Abu said he plans to enroll in training classes as soon as they become available.

"I love helping people," he said. "I'm hoping to be a force that will bring knowledge to the community I serve."

Many community health clinics are eager to sign up for the program because some of the work they do every day is very similar to what navigators will be doing. It's not clear yet where all of the services will be located.

At the Open Door Health Center in Mankato, for example, which has received $92,000 in federal funding already, navigators will be assigned to the local community center, churches and libraries.

"Any time when you have someone in hand who is really well-versed, it will help people with their needs," said Sarah Kruse, chief executive officer of Open Door, where 78 percent of patients are uninsured. Clinic officials said they plan to hire one full-time and one part-time navigator to reach some of the area's most underserved communities.

"Applying for health care coverage is really personal. And you don't want to talk to anyone, you want to talk to someone you feel comfortable with," said Marie Ellis, public policy manager at Catholic Charities' Office for Social Justice.

In the meantime, Abu will continue doing the work's he's already doing with clients who struggle with the complexities of health insurance.

"I'm excited to be a part of [the] world of health care now," said Abu. "I love outreach."