Investigation: Is healthcare sign up program worth tax dollars?

PHILADELPHIA (WPVI) -- The federal government has just announced plans to spend another $60 million dollars this year to fund the controversial Healthcare Navigator program.

Taxpayers footed a hefty bill for the navigators to guide consumers through the Health Insurance Marketplace and to enroll individuals in affordable health care plans last year.

But our investigation into the performance of the navigator system has put the program under congressional scrutiny.

It was one of the most expensive marketing campaigns in the federal government's history: $700 million of your tax dollars spent advertising the Healthcare Marketplace.

That's on top of a $1 billion website and $67 million doled out to local navigators who were supposed to both educate the public about the program and assist people in shopping for an enrolling in plans.

"Are we going to throw more money down a rat hole?" asked Rep. Pat Meehan (R-Pa.)

Earlier this week, the Centers for Medicare and Medicaid Services (CMS) announced they will handing out another $60 million to navigators in the next few months while some members of Congress argue they have no clear understanding what the original payload was spent for in the first place.

"Almost nothing surprises me anymore with this program. It has been filled with all kinds of problems," said Rep. Joe Pitts (R-Pa.), the Chairman of the Health Subcommittee.

"I absolutely think this is a waste of tax payer dollars," said Rep. Meehan

Over an eight month period, Action News sent more than a dozen emails to CMS, requesting records of the number of individuals each of these navigators enrolled, as a possible measure of their success.

"The taxpayers, once they find this out, are just going to be furious. It is unacceptable," said Rep. Pitts.

CMS internal records showed in Delaware, Chatman LLC got $510,577 and signed up 260 individuals. On average, that's $1,963.76 spent per single person enrolled.

In New Jersey, a navigator named Wendy Skyes got nearly $239,810 and signed up a total of 94 people. On average, that's $2,551.17 per person.

In Pennsylvania, one navigator, Mental Health America, received a $547,754 grant, but only signed up 145 people. That's an average cost of $3,777.61 per person they enrolled.

"It's outrageous! That is a misuse of taxpayer money," said Rep. Pitts.

"No one going into this knew how many number we should be hitting. There was no projection, it was just try to enroll as many people as possible, try to help as many people as possible," said Erik Soto, the Health

Exchange Program Manager for Mental Health America.

Soto says Mental Health America was operating on a minimal staff with only two navigators for several months, and battling glitches in the federal system.

"Because the system was having some issues, it was very difficult to enroll people from beginning to end. We did enroll up to a couple hundred, if I am not mistaken, just shy of the 200 mark. Around 145 does sound pretty accurate," said Soto.

But their director argues the numbers of people enrolled doesn't accurately represent the number of people Mental Health America touched through billboards, their call center, public events and other advertising.

"A lot of that money went toward advertising," said Alyssa Goodin, Director of Mental Health America.

"CMS said that our role was primarily education, outreach and also then to enroll persons," said Priscilla Chatman, Executive Director, Delaware Navigator Entity, Chatman LLC. Chatman believes education was their number one mandate and estimates their advertising and events reached 17,000 people.

"The number of people enrolled is one measure of success compared to others," Chatman said.

She argues that, although CMS numbers say they only signed up 260 individuals in Affordable Healthcare plans, she estimates they doubled that - including people they enrolled in Medicaid.

"We are certainly worked very aggressively to... increase our numbers. We want our numbers to be much larger both in terms of education, in terms of outreach and in terms of enrollment," said Chatman.

"I am not sure they should be going all over the community calling that education. The agency does a lot of that. That's another $700 million for crying out loud. There is a limit," said Rep. Pitts.

Representative Joseph Pitts Chairs the Health Subcommittee in the House, and says he plans to ask CMS for a full report, and call for a hearing before Congress as a result of our investigation.

"We will try to hold the appropriate officials accountable who are overseeing this," he said.

Until now, the number of enrollees signed up by navigators has never been released. Pitts says from the beginning the program lacked oversight, direction, and fiscal accountability.

"We will call some of them to the witness stand. We want to get to the bottom of this," said Pitts.

NJ Navigator Wendy Sykes would not return multiple calls and emails. Sykes and Chatman LLC in Delaware were both awarded grants again, but Mental Health America in Pennsylvania was not renewed as a navigator.

Not all navigators had the same enrollment challenges. The Pennsylvania Association of Community Health Centers signed up nearly 7,000 people, at an average cost of about $100 per person.

In a statement, Center for Medicare and Medicaid Services Spokesperson Alicia J. Hartinger said:

"Navigators do more than just help people enroll in a Qualified Health Plan. Navigators are a vital resource for Americans by not only helping them enroll in coverage through the Health Insurance Marketplace, but also educating them about health insurance in general, including their health care options through the Marketplace and public programs including Medicaid and the Children's Health Insurance Programs. Navigator grants are given to trusted community organizations that have a track record of working in their communities. Navigators around the country are actively helping consumers learn about their health insurance options, enroll in the coverage, and find the plan that is best for themselves and their families."

For More:

2014-2015 Healthcare Navigator Grants:

http://www.cms.gov/

2013-2014 Healthcare Navigator Grants:

http://www.cms.gov/