Cheryl Isabell, a health care navigator and Milwaukee community engagement lead for Covering Wisconsin, distributes health insurance resources during a community event last month at Victory Christian Academy. (Photo by Julius Shieh)
By Julius Shieh
This story was originally published by Milwaukee Neighborhood News Service, where you can find other stories reporting on fifteen city neighborhoods in Milwaukee. Visit milwaukeenns.org.
A steep funding cut expected to take place later this year threatens to gut Covering Wisconsin, a statewide health insurance navigator program that provides free guidance and other resources to help people access health coverage.
Covering Wisconsin, enacted as a result of the Affordable Care Act in 2014, employs dozens of expert navigators to help people enroll in and find options for health insurance, including Medicaid and Medicare. The program assisted over 97,000 consumers with insurance-related issues in Wisconsin last year and helped nearly 10,000 individuals with insurance enrollment.
A funding cut to navigator programs nationwide, announced by the Centers for Medicare & Medicaid Services in February, would reduce current navigator funding by 90% by the time it takes effect on Aug. 27
Covering Wisconsin received $3.1 million in federal funding during the 2023-2024 budget cycle, according to federal navigator and enrollment data. A 90% cut would reduce that to around $300,000.
“With a funding cut, our work will be more limited,” said Allison Espeseth, director of Covering Wisconsin.
Local fallout
While state specific information about the funding cut has not yet been announced, any reduction would impact Covering Wisconsin’s services significantly.
Nearly 75% of the organization’s current funding comes from federal money, according to a statement from Elizabeth Rothe, workforce and affiliates liaison for Covering Wisconsin.
Currently, Covering Wisconsin supports and provides funding for 10 regional and affinity enrollment networks across Wisconsin, with three serving Milwaukee County. Health care navigators also support local health centers, providing free insurance assistance directly to patients.
“We are indeed concerned about the announced reduction in funding for navigators,” said Richelle Andrae, associate director of government relations at the Wisconsin Primary Health Care Association, an organization representing community health centers in Wisconsin.
While some health centers have certified enrollment counselors who can assist with health insurance needs, Andrae said that Covering Wisconsin’s navigators are an invaluable resource that would be difficult for individual organizations to recreate.
“(Navigators) are the experts on health insurance issues,” Andrae said. “We look to them as organizations and as patients to have the right answers on very complex health insurance questions.”
Pamphlets detailing health insurance resources are displayed on a table during a community event last month at Victory Christian Academy, 2840 S. 10th St. in Milwaukee. (Photo by Julius Shieh)
Who will be affected?
While the health insurance navigator program was introduced as a part of the Affordable Care Act, navigators help anything insurance related, not just with issues related to ACA plans.
Navigators offer free help for all individuals, including those who need enrollment and insurance assistance with Medicare and BadgerCare Plus, Wisconsin’s Medicaid system.
“We’ve become a trusted source. We build relationships,” said Cheryl Isabell, a health insurance navigator and Milwaukee community engagement lead for Covering Wisconsin.
Navigators often work within communities, organizing events and working to distribute information about health insurance as well, Isabell said.
“It’s not only about providing this resource, but making sure that people are educated, “ Isabell said. “Doing this work – it’s my passion – to help people have access to care.”
A smaller navigators program could also lead to lower insurance enrollment rates, Andrae said.
Funding for the navigators program was slashed by nearly 80% shortly after the start of the first Trump administration in 2017, which led to decreased health insurance enrollment numbers, especially for low-income adults and adults who speak a language other than English at home.
“This means fewer people will access preventative care, and more people will access high-
cost emergency care,” Andrae said.
What happens now?
Despite the looming threat of funding cuts, Covering Wisconsin and the national health insurance navigators program are a requirement of the Affordable Care Act and will continue to exist, Espeseth said.
“We really want to make sure people know that they should reach out to us,” Espeseth said. “They should not hesitate, now or in the future.”