What are Navigators, and why do we care about them? 

July 7, 2018 / Author: Jacy Warrell, Executive Director – Tennessee Health Care Campaign

What are Navigators, and why do we care about them?

Tennessee’s uninsured rate is at an all-time low of only 9%. The progress made over the last 5 years is thanks to the Affordable Care Act (ACA) as well as the GetCovered Tenn Coalition. The coalition, led by Tennessee Health Care Campaign (THCC) and Family and Children’s, employed 27 “Navigators,” or marketplace enrollment experts, across the state.

Last week marked the end of the program, as we know it. The Centers for Medicare and Medicaid Services (CMS) recently announced that program funding (which was used to hire the 27 Navigators in Tennessee) would be cut from $1.1 million to only $300,000 statewide. Adding insult to injury, future grants will likely go to for-profit brokers who operate call centers rather than providing direct outreach in communities.

Losing Navigators will hurt pregnant mothers, children, and their caregivers.

This is because Navigators also played a critical role in enrolling people in the state Medicaid program, TennCare. In fact, of the 2,400 people THCC’s 4-person staff enrolled during the past year, 85% of them qualified for TennCare. Roughly 90% of the calls we receive on our statewide 844-644-5443 hotline are TennCare eligible and have tried unsuccessfully to find assistance with health care elsewhere in their community. The Insure Our Kids campaign, which aims to enroll every eligible child in health insurance, also relies on this hotline to connect families to enrollment assistance.

Who will help, if not Navigators?

Not the for-profit brokers.  They will not be compensated for enrollments and, therefore, have no incentive or desire to learn the complexities of TennCare eligibility. Health departments have people dedicated to helping with TennCare enrollment, but only for pregnant mothers.

Federal Qualified Health Centers (FQHCs) may provide assistance, but they vary in their capacity. Additionally, not every community has a FQHC within a reasonable driving distance.

How can you help?

1.     Volunteer. Without Navigators, it will be extra important to have volunteers ready to assist with TennCare applications. THCC recruits and trains volunteers directly, or we support other organizations who want to assist with enrollment by training and referring callers to them. As a volunteer, you will have flexible scheduling options and may help enroll by phone or in person. If you are interested, please email THCC.

2.     Protect TennCare. TennCare will undergo many changes the next couple of years including the implementation of a new online portal and work reporting requirements. These changes will require an additional level of skill among a population that traditionally has low literacy, low technical skills, and limited access to a computer. Help us to advocate for easier work requirement reporting rules by submitting a letter to the Division of TennCare.

3.     Attend THCC’s Annual Conference, September 15th at the Nashville School of Law. Our conference is a great opportunity to network with others who are passionate about health care reform, learn from Tennessee policymakers and community-based organizations, and re-energize. Speakers will include people from Division of TennCare, Senator Alexander’s Office, Tennessee Charitable Care Network, and Tennessee Justice Center, just to name a few.

Personal Note

Thanks to Tennessee Justice Center for its dedication to advocacy, assisting with TennCare appeals, and for sponsoring our annual conference! We look forward to having both Chris Coleman and Keila Franks as breakout session speakers!

About THCC

Tennessee Health Care Campaign (THCC) was incorporated as a 501(c)(3) in 1989 with a vision for all Tennesseans to have affordable, high quality, and equitable health care. Over the course of our 30-year history, we have led advocacy efforts to expand Medicaid to pregnant mothers and children, served as an ombudsman program to help TennCare applicants, and mobilized volunteers to support direct outreach and enrollment of uninsured Tennesseans.

About Jacy

Jacy Warrell, MPA, is the current Executive Director of Tennessee Health Care Campaign. She has worked with groups dedicated to improving the health and well-being of children, families, and communities for over 15 years. This work has included promoting access to healthy schools, communities, and health care in states across the nation.