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Exchange Assisters Want More Training To Help Consumers — Even After They Enroll

With the Nov. 15 kick-off for this year’s health law enrollment season fast approaching, the need for more training for the  people who help consumers navigate the health insurance marketplace is growing increasingly clear.

Affordable Care Act navigator Adrian Madriz (R) speaks with Lourdes Duenas, who is looking for health insurance, during a navigation session in October 2013 in Miami, Florida (Photo by Joe Raedle/Getty Images)

For example, 92 percent of health insurance marketplace assister programs say they want more preparation than they received last year, according to survey findings released last month by the Kaiser Family Foundation.

This figure, highlighted during an Aug. 5 briefing, came out of a larger survey  conducted after the first open enrollment period concluded last spring. The survey polled people who supervised assistance efforts by navigators, in-person assisters, certified application counselors, federally qualified health centers and federal enrollment assistance programs which were promoting federal and state-based health care exchanges.

Out of 843 respondents, 41 percent indicated a desire for more training about how to help consumers after they enrolled in health plans. The same proportion wanted more support in addressing “tax filing issues,” according to the report. About 39 percent of respondents indicated the need for further training in distinguishing between qualified health plans. The same figure wanted more training in interpreting how immigration status shaped eligibility.

These numbers do not come as a surprise to people already involved in trying to help consumers use the health law’s online marketplaces.

“I don’t think it’s a secret that people wanted more training,” said Rochelle Webb, program manager at Cognosante, a federally contracted company that worked on targeted enrollment assistance in multiple states.

Programs working with received training through the federal Centers for Medicare & Medicaid Services, while those handling state exchanges were certified by the individual state. Some states introduced additional qualifications for navigators, such as Georgia, which required that they pass the same exam insurance brokers take.

The federal curriculum required about 20 hours of training, plus online assessments.

Although she called the federal curriculum “comprehensive,” Webb said assisters with whom she worked and communicated last time around had wanted more hands-on preparation before the websites’ initial launch. Instead, assisters ended up having to figure out many of the particulars when they were already in the trenches.

CMS is still developing this year’s training, which, based on current scheduling information, will be available in September. It’s expected to attempt to tackle some of these issues.

The July KFF report indicated that more than 90 percent of assisters had been contacted by consumers after they enrolled in insurance plans, with those consumers seeking additional help.

Given most state experiences with open enrollment last year, the survey results aren’t surprising, said Lena Hershkovitz, vice president of eligibility for programs at the state assister program HealthCare Access Maryland.

“We’ve identified the need for some supplemental training for our staff,” Hershkovitz said.

Her organization plans to enhance assister-education efforts, emphasizing elements such as common insurance terms, household makeups and interpreting tax and immigration documents, she said. And a good portion of assister work necessitates “on-the-job” training.

But even with these efforts, Hershkovitz said she imagines assister programs across the country will likely continue identifying new areas in which they could use more help. She doesn’t expect the rate of assistors who want more training to decline.

“Different training topics will likely arise to the top” of assister-identified needs next year, she said. “Continuing education is going to continue to be important.”

In this survey, which was conducted April 24 to May 12, participants were asked to identify topics on which they would like further training, a list that included the option of “no additional topics or issues.” About 8 percent selected that option. The results were published in a July report examining how assister programs worked during the Affordable Care Act’s initial rollout.