Francine Hahn
Francine Hahn

When the U.S. Affordable Care Act mandated insurance coverage for all adults and their dependents, and for those not already covered by Medicare or an employer's plan, the Maryland Health Connection was set up as a marketplace where people can shop for the coverage they need.

Some people may qualify for Medicaid on the basis of their income, others for federal subsidies to reduce the cost of a plan and anyone choosing a plan has many options and a range of plans to choose from.


Francine Hahn is a Navigator with the Door to HealthCare, one of the people trained to assist people in Carroll County understand their health insurance options through the Maryland Health Connection.

Hahn practiced public interest law in Baltimore City for 16 years before becoming a Navigator last March. Her legal experience in Medicaid appeals and expertise with regard to other public benefit programs made transition to the Navigator position an easy one, she said, and her lifelong passion for social justice made it a natural fit.

The Times recently interviewed Hahn on the what a Navigator does, what the job is like and how it feels to be part of a historic change in the way health care is delivered in Maryland.

Q: What is a Navigator and when did you first begin working as one?

A: A Navigator is a person who is state-certified to assist consumers with applying and enrolling in both Medicaid and qualified health plans on the Maryland Health [Connection]. In addition, Navigators explain the tax subsidy and other financial assistance that is available to qualified consumers and provide outreach and education services to the community. I became certified as a Navigator in March 2014.

Q: Open enrollment lasts from Nov. 15 to Feb. 15. What do Navigators do during the intervening months between open enrollment periods?

A: Navigators continue to work in the community after open enrollment, reaching out to the uninsured and underinsured populations by providing education about affordable health insurance options. We enroll consumers who qualify for plans outside of open enrollment due to special circumstances, and assist with Medicaid enrollment year-round. We also participate in professional development activities and plan enrollment and outreach events for the next open enrollment period.

Q: More Marylanders enrolled in the first few weeks of open enrollment this year than enrolled in the entire open enrollment period last year, 72,600 enrolled through Jan. 6 this year compared with 66,000 from November through February last year. What do you think made things work so much more smoothly this year?

A: All players have been through the process once — Navigators, Assisters, insurance brokers, consumers, community agencies, etc. It is no longer a brand new consumer product. Consumers and staff have been able to enroll online since the beginning of the enrollment period.

Q: What are the most common questions and/or misconceptions you hear from people when they begin looking for a health plan for the first time?

A: Health plans can be structured quite differently, in terms of the monthly costs, the network of providers and certain out-of-pocket costs a person may have to pay to use health care services. Also, there are many health plans from which to choose. I have found that many people, understandably so, do not understand the complexities of health insurance. Our job is to take time to explain the main features so an informed decision can be made by the consumer based on his or her health needs and financial situation.

Q: How do people typically react when they learn they qualify for a subsidy or for Medicaid? Are there a lot of folks who qualify that did not believe they would?

A: Many people are surprised to find they qualify for a subsidy or Medicaid. Many individuals never dreamed that they could afford a health insurance plan and they feel such a sense of relief knowing that they can get the medical care they have been putting off due to lack of insurance. I have had some younger consumers in their 20s who receive financial assistance with the out-of-pocket expenses of the insurance but not the monthly premium. They are amazed that a policy can cost around $110 a month and have no deductible — originally $1,300 — and low co-pays and co-insurance.

Q: There's a lot of varying opinions about the Affordable Care Act. Do you see a lot of people who grumble about the individual mandate? What do you tell them? And what about outside of work: If you're at a party and someone asks you what you do, how do they react when you tell them you're a Navigator?


A: Not everyone agrees with the ACA. Depending on the circumstances, I may focus on some of the most important changes that have already helped so many people, for instance, how preventive/wellness care is free, children can stay on their parents' health insurance up to the age of 26 and women have parity in health care. I'm sure I get a mixed reaction when I'm out but I have never been one to take notice. I love what I do and I am proud to be part of this historic moment in time.

Q: What's the strangest or most memorable question or situation you have had on the job thus far?

A: The most memorable part of this job will be the Carroll County team of people I have the honor to work with every day. It is a team effort to reach out to a geographically diverse county that bobs in between suburban and rural. Our agency partners are incredibly supportive. All of the cooperation and support has made us more nimble and responsive to the needs of the community.

Q: What would you say to any readers who haven't yet researched a health plan and need to do so this year?

A: Visit to do your homework if you can, and then come visit one of us for further assistance. Appointments can be made at any of our Carroll County sites at or by calling 1-855-288-3667. We will visit the various library branches until mid-February. The schedule is at

Reach staff writer Jon Kelvey at 410-857-3317 or