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Sapphire Community Health

The deadline for enrolling in an Affordable Care Act health insurance plan is coming up fast. And Ravalli County’s only entity that helps people nagivate the system is feeling the pinch.

Nicole Paddock is employed by Sapphire Community Health in Hamilton as a navigator assister. It is her job to help people sort through different health care insurance options that include Medicaid, Medicare and policies offered on the government’s Marketplace website.

Considering the changes this past year in the Affordable Care Act, including cutting the requirement that everyone must have health insurance or face tax penalties, Paddock thought the number of people interested in signing up for federally-backed insurance plans would be down in Ravalli County.

So far, that hasn’t been the case.

“I actually thought it was going to be down a lot,” Paddock said. “I’ve ended up being pretty busy. I would say that we’re up 12 to 13 percent so far this year.”

The fact that income-dependent subsidies are still available, coupled with a decrease in health plan costs, could be responsible for the uptick in interest this year.

But finding someone qualified to help work through the options has become more of a challenge for people living in Montana.

Federal grants for navigators nationwide has dropped from about $63 million a year in 2016 to $10 million this year. None of that money came to Montana.

Paddock said this is her first year in the position but said she did go through "an extensive amount of training.''

Sapphire Community Health CEO Janet Woodburn said the Hamilton primary health care center did not receive any additional funding to pay for Paddock’s position.

“We felt it was important to offer this to the community,” Woodburn said. “It can be challenging to negotiate the different insurance options that are offered. Having someone who understands how the website works definitely helps.

“She has the ability to navigate through all the options,” Woodburn said. “If she doesn’t know the answer to a question, she knows who to ask.”

Sapphire Community Health has employed someone in Paddock’s position since it opened. Initially, the center did receive some funding, but when that source dried up, the decision was made to continue offering the free service.

“We felt like it was a community service that was needed,” Woodburn said.

The open enrollment period ends Dec. 15, but people can still sign up for a policy if they experience a change in their lives like getting married, getting a new job or becoming pregnant, Paddock said.

“These are life changes that happen pretty regularly,” Paddock said. “It’s nice to have that option. There are a lot of people who don’t understand what their options are. Some are already eligible for Medicaid or Medicare and they don’t know it.”

Navigating through the Marketplace website can be challenging.

“About 40 percent of the people that I’ve seen have made a mistake when they try to do this on their own,” she said. “They don’t understand the verbiage and they don’t understand why their tax credit has gone away.”

But there aren’t many people with the training to help them. There are four people working as certified application counselors at a clinic in Missoula and Paddock is alone in Ravalli County.

“That’s all for this region,” Paddock said.

Paddock sets aside one-hour blocks to help people work through the process. As of Thursday morning, she had enrolled 78 people, including 30 who were new.

“I know that I’ve alleviated a lot of stress for people when they learned they could afford to get health insurance,” she said.

Paddock’s afternoons are pretty much booked through Saturday, Dec. 15 (a day she plans to work). If people are interested in going through the process, she urged them to get an appointment by calling 541-0032.

They will need to bring wage information and social security number for any dependents.

“I get help them navigate through all the insurance options,” she said. “I can usually get them into something. People just aren’t educated about it. So they don’t know. That’s something I can help with.”

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Associate Editor

Reporter for The Ravalli Republic.