Limitations imposed by Ohio lawmakers who oppose the Affordable Care Act (“Obamacare”) have forced Cincinnati Children’s Hospital Medical Center to give up a $124,419 federal grant that would have gone toward helping uninsured Ohioans navigate new online marketplaces for health insurance.
Specifically, the state law, which Gov. John Kasich signed on April 30 and went into effect on July 30, excludes any organization that receives payments from a health care payer, such as an insurance company, from being designated as a “navigator.”
The designation is necessary for Cincinnati Children’s Hospital to receive the federal grant, which is part of national outreach efforts to enroll as many Americans, especially young adults, into Obamacare’s online marketplaces when they open for enrollment on Oct. 1.
Without the designation, Cincinnati Children’s Hospital was forced to give up the federal money, Cincinnati Children’s Hospital spokesperson Terry Loftus told CityBeat.
State legislators passed the restrictions to clarify regulations on navigators that avoid potential abuses and conflicts of interest.
But Obamacare’s supporters claim the state law is part of a nationwide effort from state and federal Republicans to make Obamacare more difficult to implement.
The federal government intends to sign up 7 million people into Obamacare’s online marketplaces, but 2.7 million have to be young adults to keep costs low. Otherwise, older, less healthy Americans will fill up the marketplaces, exhaust health services and drive up costs.
Supporters of Obamacare acknowledge that signing up so many young adults will be difficult, so they’ve taken to national and state-by-state education campaigns that tell young adults about the benefits and cost savings made available through the president’s signature health care law.
But opponents, particularly Republicans, are preventing some of the efforts by investigating navigators and passing legislation in state governments that limits what navigators can do and who can be classified as a navigator.
Most recently, Republicans in the U.S. House Energy and Commerce Committee sent a letter to groups participating in the navigator program with a series of accusations and questions.
“This is a blatant and shameful attempt to intimidate groups who will be working to inform Americans about their new health insurance options and help them enroll in coverage, just like Medicare counselors have been doing for years,” Erin Shields Britt, spokesperson for the U.S. Department of Health and Human Services, told The Hill.
For the uninsured, not knowing about the online marketplaces could mean losing out on opportunities to obtain health insurance at lower costs. Recent reports have found that Obamacare’s online marketplaces and tax subsidies will lower costs for Ohioans in the individual health care market.
An Aug. 29 study from the RAND Corporation, a reputable think tank, found health care premiums will rise to an average of $5,312 under Obamacare in 2016. Without the law, premiums would reach an average of $3,973 that year. But when Obamacare’s tax credits are plugged in, the average Ohioan will only pay a premium of $3,131 — $842 less than he or she would pay without the law.
Avik Roy, a conservative health care economist and prominent critic of Obamacare, found even better results for Ohio. His model found premiums will drop by 30 percent in Ohio, although they’ll rise by 24 percent on average for 13 states, including Ohio, and the District of Columbia as a whole. Unlike RAND, Roy’s calculations don’t take subsidies into account, so the final cost for the average Ohioan is likely much lower.
The numbers only apply to Ohioans in the individual health insurance market. Under Obamacare, individuals will be able to enroll for health insurance through an online marketplace. The majority of Americans who get health insurance through their employers or public programs fall under different rules and regulations.
It’s unclear how much Republican opposition will ultimately play into the numbers. But for Cincinnati Children’s Hospital, it means $124,419 less to help its neediest, less knowledgeable patients.