Navigators work around continued glitches

CLEVELAND-Since she was hired as a navigator by the not-for-profit Parma Health Ministry last November, Dona Kiner has been stymied by the technical problems that persist with the federal insurance exchange website, healthcare.gov.

The problems haven’t stopped Kiner from assisting local residents of this Cleveland suburb make sense of the new federal online insurance marketplace, however.

Adorned with a large shoulder bag, Kiner schedules presentations at local libraries,  a community center and other public places where she conducts education for potential enrollees. It is also her job to walk applicants through enrollment forms.

Not that it’s been easy.

“We’re still dealing with glitches,” Kiner says, referring to the lack of connectivity between the federal website and Ohio’s Medicaid computer system, for example.

Kiner has become a practical expert in Ohio’s new Medicaid enrollment procedures, helping dozens of individuals determine if they are eligible-delivering them directly into the state’s growing Medicaid pool. She estimates that 95% of the people that she has assisted during the last few weeks are Medicaid eligible.

The first step in the Medicaid application process, Kiner says, is to bypass the healthcare.gov online exchange tool. It is still problem-plagued by her estimation, more than a month after federal officials announced it was working just fine for “the vast majority of visitors.”

By using the federally operated exchange, Medicaid-eligible applicants risk falling into an administrative limbo they might not escape any time soon.

Enrollment grows

Since Ohio’s expanded Medicaid enrollment period began December 9, 2013, an estimated 65,000 Ohioans who have applied for Medicaid through healthcare.gov are still shut out of Ohio’s system because the platform is unable to transfer data from individual applications onto state computers, says Samuel Rossi, spokesman for the Ohio Department of Medicaid.

“On December 28, representatives from healthcare.gov began calling those Ohioans who applied through the federal website for Medicaid and told them to reapply at the state level because the transfer is not going to be complete,” Rossi says.

With the help of navigators like Kiner, and solicitation of state and federal officials, Ohio Medicaid applicants are reapplying at a fast clip, causing Ohio Medicaid enrollment figures to jump. Since December 9, 2013, Ohio has added 39,000 enrollees.  

“Even if it takes 30 days or even a few more to get enrolled, it’s still quicker than healthcare.gov at this point,” Rossi says.

Ohio is one of 36 states using the federal online marketplace for enrollment. It also joins 25 states and the District of Columbia moving forward in expanding Medicaid under the Affordable Care Act (ACA). In October, the Centers for Medicare and Medicaid Services (CMS) approved a state plan amendment, extending Medicaid eligibility in Ohio.

The move also provides Ohio $2.5 billion in federal funds through ACA.

Expansion of the Ohio program is expected to add about 366,000 uninsured residents to the rolls by 2015, including 231,000 children, parents and seniors who are now eligible, but who are not yet enrolled.

Two exchange sign ups 

Since November, Kiner has successfully helped just two people navigate through healthcare.gov. Packing her bag as she prepares to leave the Parma Public Library, Kiner says it remains a work in progress.

Some fixes already implemented have resulted in improved performance of healthcare.gov. At the end of 2013, more than 2 million people had signed up for coverage, with about half of that number enrolling through the federal exchange, according to government estimates.

CMS hired Accenture, a consulting and technology services company, in early January to fix the functionality of healthcare.gov. When the technical problems are finally resolved, it should be easier to steer consumers through the marketplace, Rossi says.

“I will say once the federal website is working well, their website and our website will be connected so the data will be able to be transferred in real time,” Rossi says.