Federal grants of $599,918 have been awarded to two Alaska nonprofits to provide assistance and counseling to Alaskans attempting to navigate a new federally operated health insurance exchange scheduled to become active Oct. 1.
Grants were made to the United Way of Anchorage and the Alaska Native Tribal Health Consortium. Susan Johnson, Region 10 director for the U.S. Department of Health and Human Services, made the announcement at a press conference Aug 15.
United Way will coordinate counseling services in Anchorage, Fairbanks and Juneau and in the Matanuska-Susitna Borough in partnership with another organization. The effort is primarily to target uninsured Alaskans, which are estimated to number about 40,000, to explain how they can obtain health coverage through the new insurance marketplace.
The Alaska Native Tribal Health Consortium, or ANTHC, will coordinate counseling in rural communities working with the regional tribal health corporations that provide medical services.
Counseling will be available in multiple languages including Yupik, Johnson said.
Under the federal Affordable Care Act, a federal insurance exchange was developed for Alaska after Gov. Sean Parnell turned down the opportunity for the state to create an exchange.
However, the state Division of Insurance must still approve insurance companies who will sell policies through the exchange, Johnson said. She said she has heard that at least two companies have filed information on policies they will offer with the division, but the identities of the companies are not yet known.
Companies selling policies must offer insurance that meets certain minimum requirements in the federal law.
In January, all Americans will be required to have health insurance or pay a penalty. Federal subsidies are available for lower-income people who meet certain guidelines.
An announcement from the Department of Health and Human Services said “navigators,” or people providing counseling, will be required to take 20 to 30 hours of training to be initially certified and will be required to take additional training and to renew their certification yearly.
They also will be required to adhere to security and privacy standards including how to safeguard consumers’ personal information. Navigators will be subject to criminal penalties for violations, according to the announcement.
In the Aug. 15 briefing Johnson said there are probably no big differences in how the new federal exchange will function in comparison to how a state-operated exchange would have performed because both would help consumers compare different insurance policies being offered by companies. The exchanges also help consumers connect to special services, such as the subsidies on premiums for lower-income people.
However, states which opted to set up their own exchanges took advantage of the opportunity to “brand” the exchange with a regional identity, Johnson said. Oregon, for example, has its name and a logo on its exchange and is promoting it through volunteer artists and singers to make Oregonians feel comfortable in using it.
Also, states which operate their exchanges are using a wide array of state agencies, like motor vehicle licensing offices and kiosks in public areas, to get information out.
An important advantage of a state-operated exchange is that the state is able to negotiate with insurance companies who apply to participate to fine-tune their policies, Johnson said. This has happened in U.S. northwest states with their own exchanges.
Alaska cannot do this because a federally operated exchange cannot offer the state that power, she said. The state Division of Insurance can only certify that the insurance companies participating meet requirements of state law.
At the briefing, Valarie Davidson, government affairs director for ANTHC, said her organization and its partners will offer the new counseling through an extensive array of counselors who now work in rural communities.
It’s important to work through the existing network, she said. “People will go to people they trust for information,” Davidson said.
Getting people signed up for health insurance in rural areas is important for several reasons. With their own insurance to supplement Indian Health Service care rural Alaskans will be able to get care with any provider, and will not be restricted to using a tribal health facility, she said.
However, if rural Alaskans with insurance use a tribal facility, such as in a rural hospital or clinic, the regional tribal nonprofit will be able to bill the insurance company for payment.
This will be an important new source of revenue for the tribal health corporations because of chronic underfunding of the federal Indian Health Service by the federal government.
Today the Indian Health Service funding only pays about 50 percent of the actual cost of care in rural facilities, and the tribal providers are seeking other revenues, like Medicaid, to offset the deficits, Davidson said. Private insurance purchased through the exchanges would create another source of revenue.
“Many of our tribal members have told us they would like to buy health insurance,” as a supplement, she said.
Many rural Alaskans are in lower income ranges and would likely qualify for many of the subsidies, Davidson said.
Tim Bradner is a reporter for the Alaska Journal of Commerce.