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With seven weeks to go until the March 31 deadline for state residents to buy health insurance or face federal tax penalties, gaps remain both in the outreach effort to let people know about the new federal health insurance marketplace and in the programs to enroll them.
One of the largest gaps: six New Jersey counties that did not receive federal funding for so-called Navigators, organizations that get the word out about ACA coverage and help residents sign up for what they need.
The problem can be traced back to Gov. Chris Christie's decision to rely on a federally run marketplace, rather than setting up a state-operated system, which severely limited the state from qualifying for federal funds that can be used for outreach.
What makes the situation particularly frustrating for healthcare advocates is that federal money may be available. The feds originally gave New Jersey $7.67 million to build its own exchange, but when the administration opted not to, the funds were off the table.
Or are they? State and federal officials are-- which must be spent by February 22.
Meanwhile, Somerset County’s estimated 26,732 uninsured residents aren’t directly served by either of the two largest federally funded Navigator organizations. The federal government selected the initial Navigators, since the state has avoided any involvement with the marketplace.
In fact, none of the five organizations that werehave been assigned to Somerset or five other counties -- Hunterdon, Middlesex, Passaic, Sussex, and Warren.
That means Somerset residents must travel to a neighboring county to receive assistance at a federally qualified health center.
Healthcare advocates say that other nonprofit organizations have stepped in to partially fill these gaps. They noted that the federal government has hired two additional firms to assist with insurance applications, and that the work of volunteers and other organizations means that there are enough people to assist uninsured residents through the enrollment process.
There are a total of 175 offices in the state that provide assistance to residents looking to enroll, including organizations that operate multiple locations.
But advocates are concerned that not enough residents may ever learn that assistance is available. They are strongly urging the state Department of Banking and Insurance to spend $7.67 million on outreach.
That would be in addition to the $2.02 million available through federal Navigator grants for enrollment assistance.
Had Christie opted to build a state exchange, even more money would likely be available. For example, the feds awarded New York $27 million in grants to 50 organizations to provide in-person insurance assistance to people in all of the state's 62 counties.
New Jersey's $2.02 million, in contrast, only paid for Navigators in 15 of its 21 counties.
When he chose not to build a state exchange, Christie cited potential costs to the state.
“Some of us were a little surprised that there were some gaps” in the geographic coverage provided by the Navigator grants, said Raymond J. Castro, senior policy analyst for New Jersey Policy Perspective.
Maura Collinsgru, health policy advocate for New Jersey Citizen Action, noted that federal contracts with information technology companies Cognosante and SRA International have supplemented the Navigator grant recipients. Cognosante has an office in the Basking Ridge section of Bernards Township, Somerset County, while SRA International is operating an office in Wayne, Passaic County. Both counties aren’t served by a federally funded Navigator.
“That’s been a big boost in the supply chain,” Collinsgru said.