When Texas’ health insurance exchange fires up Oct. 1, the United Way of Tarrant County will have a leading role in educating hundreds of thousands of Texans on how to use the exchange, a provision of the federal Affordable Care Act.The local United Way chapter landed a $5.9 million grant last week to head a statewide consortium with 16 other partners to hire about 80 “navigators,” who will guide eligible consumers through the process. Nine of those navigators will be assigned to Tarrant County and the rest around the state, said Tim McKinney, president of the organization.The United Way and other grant recipients have less than six weeks to hire the navigators, who will be trained by the U.S. Department of Health and Human Services. Navigators must undergo 20 to 30 hours of training and pass a certification test, according to HHS.“This has got to move fast,” McKinney said Wednesday. The United Way sought $6.7 million in its grant application, he said, so it must adjust its plans to accommodate the smaller amount. A total of $67 million was awarded nationwide. Eight groups in Texas shared $10.8 million in grants, with the United Way’s the largest by far. Its grant was also the largest of 108 given out nationally.Carrying out healthcare reform in Texas is expected to be particularly challenging because of political opposition to the program from residents and elected officials alike.The United Way of Tarrant County’s consortium hopes to reach 62,000 Texans in face-to-face meetings and 500,000 through phone calls and community meetings, McKinney said. Tarrant County has about 341,000 uninsured residents, and Texas has about 4.9 million, he said.On its website, the United Way has posted links to apply for its navigator jobs, called Consumer Health Insurance Marketplace and Education Services, or CHIMES. For more information, visit www.unitedwaytarrant.org, go to “Get In Touch” and click on “ Careers.”“Navigators will be among the many resources available to help consumers understand their coverage options in the marketplace,” Health and Human Services Secretary Kathleen Sebelius said in a statement last week. “A network of volunteers on the ground in every state — health care providers, business leaders, faith leaders, community groups, advocates and local elected officials — can help spread the word and encourage their neighbors to get enrolled.”Wendell Watson, spokesman for Arlington-based Texas Health Resources, said the hospital network expects to work with other community organizations in that effort. “We are developing plans for communication and education, but it is a little early to know exactly how we might be able to complement what United Way will do,” Watson said. Texas Health, one of North Texas’ biggest healthcare systems, includes the Harris Methodist and Presbyterian hospitals.Health marketplaceThe exchange, formally called the Health Insurance Marketplace, offers a range of insurance policies in each state. Discounts are offered to people whose household income is 100 to 400 percent of the federal poverty level.For an individual, that would be between $11,490 and $45,960, according to Families USA, a healthcare advocacy group. For a family of four, the income range is $23,550 to $94,200. The lower the income, the larger the discount on the policy.Nearly half the state’s uninsured, or roughly 2.4 million Texans, are expected to qualify for some level of discount.Texas is one of 27 states that voted not to operate their own exchange, meaning the federal government will operate it. Exchanges in all states launch Oct. 1, and policies bought through them take effect starting Jan. 1.While the healthcare act, often called Obamacare, is a centerpiece of President Barack Obama’s administration, McKinney said he doesn’t think United Way’s grant work will affect its nonpartisan image.“We thought about it,” he said. “Our view is that the Affordable Care Act is the law and that providing information and education on healthcare is right in line with our mission to work in areas of education, income and health.”‘Very pleased’Deborah Peoples, head of the Tarrant County Democratic Party, said she was “very pleased” to see such a sizable grant go to a local organization. She said party officials plan a Sept. 5 meeting to plan their own educational efforts regarding the healthcare act.Jennifer Hall, chairwoman of the Tarrant County Republican Party, said she needed to review the United Way’s award before commenting.Last week, Texas Attorney General Greg Abbott and 12 other attorneys general sent a letter to Sebelius expressing concern that the federal government’s screening process does not require uniform background checks on navigators. They also expressed worries that navigators will not undergo sufficient training.“Navigators will fill a critical need by providing knowledgeable in-person assistance through familiar and trusted community groups, to help people apply and sort through new coverage options,” said Stacey Pogue, an analyst with the Center for Public Policy Priorities in Austin, a supporter of the Affordable Care Act.This session, state lawmakers approved Senate Bill 1795, which authorizes the Texas Department of Insurance “to regulate navigators if it determined that federal standards did not ensure they were qualified to perform their duties or avoid conflicts of interest,” The Texas Tribune reported. That measure, which takes effect Sept. 1, allows the department to enact rules that protect patient privacy and prohibit navigators from accepting payments from health insurance companies or posing as an insurance agent.The department is still in the rule-making process and has not determined whether those provisions will be enacted before the exchange launches Oct. 1.
Jim Fuquay, 817-390-7552 Twitter: @jimfuquay