EDITORIAL: Outreach to improved health insurance exchanges

Akron Beacon Journal (OH)

Sept. 11--The effort to stabilize the online insurance exchanges has begun on Capitol Hill. Governors and state insurance commissioners shared their views with a Senate committee last week. The consensus, beyond the need for cost-sharing reduction payments, reinsurance mechanisms and greater flexibility for states? Keep the money flowing to outreach and enrollment initiatives.

Unfortunately, the Trump White House, just days earlier, announced plans to slash the advertising budget for the upcoming enrollment period. The funding would go from the current $100 million to $10 million next year. More, federal support for "navigators," hired by nonprofit organizations to guide people through the individual market, would be reduced 40 percent, from $62.5 million to $36.8 million.

These initiatives serve as the primary vehicles for enhancing awareness, understanding and boosting the number of people who gain health coverage. Contrary to the claims of the Trump administration, they have been successful.

Researchers from the Robert Wood Johnson Foundation and the Wesleyan Media Project recently looked at Kentucky, where a change in governors saw a dramatic shift. The state went from an aggressive program to promote enrollment to practically none at all.

No surprise that enrollment levels have declined. The researchers found that television advertising proved the most effective.

State-based exchanges, as in Kentucky, must support their own outreach. California spends roughly $100 million a year, or a sum equivalent to what the federal government has devoted to Ohio and the three dozen other states using the federal exchange.

Now cut by 90 percent?

Officials at the Department of Health and Human Services argue that consumers already are familiar with the exchanges. Yet this has been such a confusing time, the White House and the department casting much doubt about the exchanges, along with shrinking the enrollment period by six weeks.

If anything, outreach is more important. Recall the start of the Trump presidency, the administration ditching a last-minute advertising campaign, and enrollment numbers falling off.

Lisa Hamler-Fugitt, the executive director of the Ohio Association of Foodbanks, has seen how well the navigator concept has worked. She greeted the news about sharply reduced support with testimonials about navigators helping families after the loss of employer-based insurance, individuals making the transition from Medicaid and workers back in school to upgrade their skills who need coverage for a time.

If the goal is to see the exchanges succeed, then it follows many will need help with something as complex as health insurance. Success depends, more than anything, on achieving a balanced risk pool, between the healthier and sicker. That, too, goes to outreach and enrollment programs. When they deliver, premiums increases are more manageable, coverage more accessible and affordable.

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