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story.lead_photo.caption Chris Pittman, left, signs up for Affordable Care Act coverage on the Missouri marketplace during the 2017 open enrollment period, with the help of an insurance counselor from Primaris. Photo by Helen Wilbers / Fulton Sun.

Big budget cuts to a federal program designed to help people sign up for Affordable Care Act coverage could affect area programs.

U.S. Health and Human Services funding for the program, known as Navigators, has been cut from $36.8 million in 2018 to just $10 million for 2019, according to HHS documents. The money will be split among 34 states. This follows a nearly $30 million funding cut from 2017 to 2018.

Primaris Foundation is a nonprofit in Columbia that provides insurance counseling services each year in Callaway County and elsewhere. Insurance Counseling Services' program director Scott Miniea said while Primaris isn't funded through Navigators, other programs in the area are.

"We work very collaboratively with people who are Navigators," he said. "We're funded by the Missouri Foundation for Health, which is not a federal program."

Primaris is part of the Cover Missouri Coalition, which primarily consists of certified application counselors (like those at Primaris) but includes some Navigators groups. He said since 2017, some of those programs have had to downsize.

"Some of them had funding that was ending and weren't necessarily expecting funding again," Miniea said. "There are fewer of us to go around because of the cuts."

That means a heavier caseload for Primaris and other non-Navigators program workers.

"Some folks, we're going to help more over the phone instead of in person because of limited funds and having more people to help," Miniea said. "We'll have to cross-refer some to other resources."

With fewer federal dollars to go around, Miniea said competition is likely to be stiffer for other grants, like the one Primaris relies on.

"But we're still here and we're still going to be helping people," he said.

Miniea said he firmly believes insurance counseling services are important.

"In our experience of doing this for five years, we've had a lot of people who still need help as the system continues to change," he said. "It's not as simple as just figuring it out. We do try to empower people to help themselves, but a lot of people do come to us to help them navigate it."

According to 2015 U.S. Census Bureau data, 13.9 percent of Callawegians are uninsured — slightly higher than in Cole County (12.5 percent) and Boone County (13.1). Primaris' goal is to make sure all Missourians have access to health insurance. All its services, from education to counseling, are free.

Primaris counselors help during open enrollment period, which starts Nov. 1 this year and runs for six weeks, and during special enrollment periods that individuals qualify for following certain life events.

"We're kind of like the HR department for people who don't have workplace coverage," Miniea added. "It's free, unbiased assistance. We're not insurance sales reps."

Visit midmoics.org to find help navigating Missouri's insurance marketplace.

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