Insurance Navigators

It’s 6:48 on a Wednesday morning, and Juven Nava and Diego Romero are departing GraceMed’s Administrative Center and heading for a stampede.  It’s the Country Kicker Stampede, a country music outdoor concert in Topeka.  They’ll pitch their tent for three days among the concert patrons to offer their help to the uninsured among them.

Unlikely place to go fishing for the uninsured, you say? Peter may have had a similar thought when someone on the shore, the resurrected Christ as it turned out, called to him to cast his net on the other side of the boat. But the truth is, the uninsured can be found in so many walks of life these days. So casting a broad net is pretty much the order of the day for Juven and his team of Health Navigators.

That’s right. These are the people who specialize in the nuances of the Affordable Care Act and the health insurance marketplace it created. While the ACA may be less than popular with some of us, what gets Navigators like Randy Benton up in the morning is knowing he’s going to be able to throw a firewall between his clients and the ravages of potentially devastating healthcare costs.

“There’s nothing perfect about it,” Randy said. “The ACA has been a shadow of what it could have been since it’s inception. But for those who can’t afford insurance any other way, it’s a shadow that effectively breaks the heat of exposure to medical bills that could literally bankrupt their families. And you can’t tell me that’s not good for the economy; it’s good for the mind, body and soul.”

When you talk with Navigators like Randy, you can’t help getting that sense of a disciple who has seen the light and is inspired to share it. That enthusiasm for helping others is an essential asset for the work they do as emissaries of hope to some of the most insurance-resistant among us.

“When the ACA Marketplace was first launched, there was a lot of low-hanging fruit,” said Juven Nava, Director of Outreach and Eligibility. “It was in the news and all over the media in a national advertising campaign.  So it was top-of-mind for a lot of people who were eager to get some coverage. A lot of the people we see these days are the ones who are willing to continue playing the odds, hoping against hope that the need for insurance will never catch up with them.”

The good news is that number is at least declining, if not dwindling. More than 31 million lives are now covered by an ACA Marketplace plan. That represents a drop in the number of uninsured of nearly 6% since the market was opened. According to the most recently reported figures, however, the bad news is that about 32 million still have no health coverage at all.  That number boils down to about 270,000 Kansans or a little under 10%.

“Living without insurance usually means you avoid getting care,” noted Diego Romero, Outreach Project Coordinator. “And that often means conditions that could have been treated become more serious and life-threatening. Then they end up in emergency rooms and ultimately in hospitals. More often than not, it results in the hospital having to absorb those expenses. Then they are passed on in the form of higher and higher costs for everyone who goes to the hospital.”

Of course, the pandemic has sent shockwaves through the ranks of the uninsured as well. As employers, many of whom  struggled to provide insurance benefits before COVID-19 arrived, had to let people go or close their doors entirely, many millions more workers lost coverage. The virus also motivated the government to extend the ACA enrollment window through the summer this year, and that has kept GraceMed’s Navigators more than busy responding to the crisis.

Some of the uninsured are eligible for Medicaid, of course, and GraceMed’s Navigators, as well as our Outreach Team, are also constantly casting their nets for those clients as well. Outreach representatives are significantly focused on signing up children for coverage under KanCare, the state’s Medicaid program. As of last year, there were more than 66,000 children in the greater Wichita area who had no health insurance.

“There’s a legacy aspect to growing up without insurance,” Juven explained. “It’s not just the chronic health problems that can develop and follow these kids throughout their lives. It’s also the fact that they come from families that lived without insurance, so they often try to make the same decision as adults. We’re trying to intervene and establish a different precedent that says insurance equals care equals health.”

Meanwhile the Navigators work with patients to establish a status for Medicaid coverage called Presumptive Eligibility. It’s basically a fast track that pre-qualifies them for Medicaid, so they can be seen immediately.

As it turned out, Juven and Diego’s trip to Topeka was cut short by high winds and torrential rains. Not a good weekend for fishing. Come Monday, though, they were back in the boat, ready to cast in a new direction.

This post originated in our State of Grace quarterly news magazine. If you would like to receive the magazine, please visit this link and give us your information. Thanks!