Navigator program director hopeful about enrollment numbers

Caroline Gomez-Tom, navigator program manager for Covering Wisconsin, is hopeful that this year’s open enrollment period will see nearly as many signups as last year, despite dwindling federal funding.

“At least here in Wisconsin, it’s not as turbulent as we saw last year,” she told

During last year’s open enrollment period for 2018 coverage, she notes Molina had left the marketplace due in part to uncertainty around the future of the Affordable Care Act. But Molina has since re-entered Wisconsin’s ACA marketplace, and the other insurers have stuck around as well.

So far, signups during this year’s open enrollment period have lagged behind last year. Though many factors are at play, Gomez-Tom says the slow signups could be explained in part by consumers choosing to let their plans automatically renew.

She explains that those who were happy with their previous coverage can wait out the open enrollment period to be auto-enrolled with the same plan by Dec. 15, when open enrollment ends.

“Many people could be doing that,” she said. “At this point, we are still ahead of where we were at in 2016.”

Last year was somewhat of a special case, she says, as open enrollment was held during a 45-day window — half the time allotted in previous years. At the same time, there was “a lot of urgency” about open enrollment due to how much ACA repeal was being discussed on the national stage.

“This year, there’s not as much awareness on a national level,” Gomez-Tom said. She says the federal push to get people enrolled is still lacking, “so we’ve relied on what we’ve been doing locally.”  

Local efforts include running several types of advertisements both in Madison and Milwaukee. Print ads were plastered at bus stops and on the buses themselves, radio ads peppered the airwaves and several ads were run in newspapers.

Gomez-Tom says Covering Wisconsin got some earned media coverage through interviews, and also held a call-in event in Milwaukee last week.

“We answered hundreds of phone calls from folks trying to figure out where to go for assistance,” she said.

Since the Trump administration took office in 2017, funding for navigator programs like Covering Wisconsin has been slashed by more than 80 percent. The Centers for Medicare and Medicaid Services cut navigator funding to $10 million for 2019. That’s down from $36.8 million last year, and $63 million in the year before.

“It continues to be hard to maintain our efforts locally,” Gomez-Tom said.

She says the entire state got just $200,000 in navigator funding this year, so those partners have shouldered most of the economic burden for the campaign. They include groups like Milwaukee Health Care Partnership and United Way in Milwaukee and in Waukesha, as well as Dane County and Madison.

“If it was just navigator funding, we would not have the reach we do at the moment,” she said. “Without community partners stepping up and realizing that there’s a real need for navigator services, I don’t know what our impact would have been this year.”

See the latest snapshot of enrollment totals from CMS:

–By Alex Moe