The Obama administration on Tuesday said it will award $54 million to community groups in 33 states to help people sign up for insurance in the new online health insurance marketplaces that open for enrollment Oct. 1.
The size of the long-awaited grants offers a glimpse into the challenges of carrying out the health law in states such as Texas and Florida, which are relying on the federal government to run all or part of their marketplaces. States setting up their own marketplaces are getting separate funding from the federal government.
The marketplaces are the key way the federal health law is attempting to provide health coverage to about 27 million people by 2016.
"There's no way that's enough money to make a difference," said John Poelman, a senior director of Leavitt Partners, a consultant working with many states to set up the marketplaces.
Stan Dorn, senior fellow at the nonpartisan Urban institute, called the money "a drop in the bucket.” "It’s not enough to enroll tens of millions of uninsured into coverage.”
>> Navigator Grant Funding By State
The $54 million to hire and train people to help consumers navigate the new marketplaces will be distributed to groups in 33 states based on how many uninsured they have. Texas and Florida, for instance, with almost nine million uninsured, will get up to $14 million.
Hospitals, county health agencies, religious group and chambers of commerce are among the kinds of groups expected to apply for the grants. Applications are due June 7 with awards being made in August.
Health experts and consumer advocates worry that people in the states relying on the federal government to run their marketplaces will get less help than those in states managing their own exchanges. For example, California, which is setting up its own exchange with federal funding, has budgeted more than $50 million for 'in person' help for consumers this year and next.
That's because the law’s framers gave states broad financial assistance to set up their online marketplaces on the assumption that most states would step up. In the end, however, only 17 states and the District of Columbia did. No separate pot was set aside for the federal or state partnership exchanges. Resources for those efforts may also be constrained because of the spending cuts imposed by budget sequestration.
"I think HHS would probably be the first to say it’s not enough, but it’s a great start, and it’s an important down payment," said Ethan Rome, executive director of the advocacy group, Health Care for America Now.
Laura Goodhue, executive director of Florida CHAIN, a consumer health group, applauded the announcement of the pot of money, but said private groups would have to pitch in to help enroll people, as well.
"The federal funding will significantly assist community based groups who are closest to serving the needs of the uninsured with the task of educating and enrolling millions of people in a short time period," she said. "However, additional support from state, local agencies, providers and others will be needed to make sure that everyone is aware of the opportunities."
Texas consumer advocates said they were happy to get funding to help the enrollment effort.
"Any money that they’re putting forward is more than there is right now, which is zero," said Anne Dunkelberg, associate director of the Center for Public Policy Priorities in Austin. "At least it’s proportional to our number of uninsured."
Adam Searing, project director of North Carolina Health Access Coalition, said his state will have far less money to reach out to the uninsured than those setting up their own marketplaces. But he blamed that on the state's politicians who opposed the law and did not want a role implementing it. “We know we will have less money,” he said.
He noted the state this week gave up $74 million in funding for the marketplaces which could have been used for outreach.