With time short and budgets slashed, Obamacare navigators go grassroots to spread the word

The people who put together Tennessee's open enrollment events and power the state's hotline are devising a last minute, grassroots strategy to let people know when and how they can buy individual health insurance.

The final six weeks before enrollment kicks off on Nov. 1 will be frantic for navigators, the people certified to help. The Affordable Care Act didn't get repealed but a last minute funding decision by the Trump administration is altering plans that were nearly cemented.

National TV ads have beamed enrollment dates — typically November through January — in the last four years. But with the federal budget slashed from $100 million to $10 million, for the whole country, navigators like Sharon Barker are thinking about alternative ways to get the word out.

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Barker, a certified navigator who is central to Family & Children's Service's enrollment efforts, is working with others to contact churches, daycares, community centers — really anywhere with a bulletin board to pin up flyers.

There's going to be a digital push to reach people on Facebook, where advertising doesn't cost as much.

She's talking with youth groups that want community service hours. Across the state, there's going to be a reliance on local newspapers and radio shows, such as Fisk University's Common Cents: The Money Show on WFSK, to find the barbers, bartenders and landscapers, and others, who maybe tune into the airwaves and don't get insurance through a job.

"I'm talking about going to Friday night football games," said Barker. "We’re all we’ve got now. People did rely on those national commercials.”

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There's a lot of unease about the future of the Affordable Care Act given the attempts to repeal it in the last few months.

But, “the law is still the law," Barker said, and navigators are willing to meet people in person to help guide them through healthcare.gov at walk-in hours at libraries or by appointment at Starbucks or apartment clubhouses — wherever it's convenient.

In the last 10 days Barker has heard from a man she's helped enroll the last four years as well as from a woman in her early 20s who will be shopping for her plan for the first time -- instead of being on her parents' plan.

"It’s business as usual. So many people are nervous — we don’t want people thinking about that. It’s here until it’s not," said Barker. "There's no reason to try to second guess what the administration is going to do. That’s our big task is to assuage people’s fears.”

FCS coordinates navigators across the state, under Get Covered Tennessee, and learned on Sept. 1 that it could see up to a 20 percent reduction to its $1.6 million grant from the U.S. Department of Health and Human Services.

Tapping into universities and civic groups to get the word out

Family & Children's Service could get some assistance from university students who want to experience in explaining policy and educating people.

Carolyn Heinrich and Michael Baker are putting into motion a plan to get Vanderbilt University students, and potentially partner with other universities around the state, who want to volunteer into place to get the word out.

Heinrich, a public policy, education and economics professor at Vanderbilt University, said some students were out at the state fair over the weekend and Baker, a graduate student, is putting together a website to coordinate efforts.

Heinrich said the outreach is part of the mission of the Scholars Strategy Network to make sure that non-partisan information about policy gets out into the world. There's an event planned for Oct. 16 to get information to potential volunteers.

"One of our concerns about the ACA — it is the law of the land right now, and it provides an option for people to have health insurance. In order for people to make good decisions they need to have good information," said Heinrich. "Recognizing this is really important, and unfortunately the current administration did a lot to cut out the process (of getting information out).”

Eric Keller, chair of the Anderson County Democratic Party, is hoping to use some of Vanderbilt's outreach efforts to help guide how people start to get advertising around his county, and more broadly East Tennessee.

Keller has worked with civic groups Indivisible Tennessee and the Women's March huddles in East Tennessee on projects, and he's hopeful that people can quickly mobilize to get the word out with events, targeted Facebook ads, radio shows and more.

The radio is important because not everyone has broadband in Anderson County and there's apprehension about whether people will be able to buy coverage in the future, Keller said.

"Without a doubt I would have done (enrollment outreach) without Vanderbilt, but why reinvent the wheel," Keller said.

Less funding, new rules and a tighter timeline

Some navigators in other states have lost their jobs already because funding is being cut.

Family & Children's Service is going to fund its staff through the open enrollment season, and think about what needs to be trimmed from the budget after it's over, said Sandy Dimick, Get Covered TN program director.

There are more pressing questions, Dimick said, such as where can FCS hold its annual event until midnight on the deadline of enrollment as well as hunting for a space with good parking to host a music-themed event to highlight the importance of the individual market to the city's music industry.

It's midnight event has typically been at FCS but the organization is in a temporary space until its new building near the Metro Nashville Public Health Department is open in 2018.

And both Barker and Dimick suspect that being available to help until the clock strikes midnight will be even more important this year. The enrollment season runs from Nov.1 to Dec. 15 — six weeks shorter than last year. Enrollment usually lags around Thanksgiving because people are busy.

People see on the news that it's the final hours and call to make sure someone is going to be there.

"It concerns me that there may be some people that don’t get the message that they only have six weeks," said Barker.

Every open enrollment has played by a different set of rules than the one previously. Navigators becoming accustomed to last minute changes.

Barker is enthusiastic and upbeat. She'll get to check in with people she's helped before, and get to talk about the intricacies of buying health insurance — a topic that makes many, but not her, groan.

“I'm always optimistic," said Barker. "I think it’s going to be great.”

Reach Holly Fletcher at hfletcher@tennessean.com or 615-259-8287 and on Twitter @hollyfletcher.