Navigators to get record-breaking $80 million to boost ACA enrollment


The Biden administration will provide federal marketplace navigators with $80 million in funding to help people enroll in health coverage during the 2022 open enrollment period, HHS said Wednesday.

That’s an eight-fold increase compared to last year and the largest pot of money ever earmarked for navigators. HHS expects the increase in outreach, education and enrollment assistance to ramp up enrollment in health coverage.

“Navigators play a key role in helping us educate consumers about health plan options. Today’s announcement builds upon the steps the administration has taken to ensure individuals and families can access quality, affordable health coverage during the COVID-19 pandemic,” HHS Secretary Xavier Becerra said in a statement.

It’s a sea change from the Trump administration’s posture towards the federal marketplaces.

Consumer advocacy groups had long criticized the Trump administration for cutting the budget for navigators, which they say are critical to open enrollment’s success. Trump’s CMS had argued that navigators enroll too few people to justify the funds they receive, but navigators insist they do more than sign people up for coverage.

After peaking at $63 million in 2016, Trump’s CMS slashed funding for navigators to slightly over $36 million in 2017. It cut their funding again in 2018 to just $10 million. The Trump administration also reduced funding for outreach outside of navigator programs by 90%.

According to a 2020 survey by the Kaiser Family Foundation, nearly five million people couldn’t find someone to help them shop, apply for and enroll in health coverage. Of the seven million people who received help to enroll, 40% of them said they probably wouldn’t have coverage if they didn’t have assistance. The same survey found that most people didn’t know if the Affordable Care Act was still in effect or that marketplace enrollment was limited to an open enrollment period, while Medicaid enrollment is open year-round.

“The survey findings suggest a shortage of consumer assistance resources, even as a lack of knowledge of ACA coverage options and how to apply persists,” KFF said in an October report. “As economic dislocation from the COVID-19 pandemic threatens jobs and possibly health coverage, more people may need to explore replacement coverage options under the ACA in the coming year. Limits on the consumer assistance capacity in federal marketplace states could add to this challenge.”

HHS said that more than 12 million consumers signed up for coverage during the 2021 open enrollment period, a 5% increase over the year before. In addition, more than 500,000 people have enrolled in coverage during the ongoing special enrollment period, which ends Aug. 15.

Navigators help people shop for and enroll in ACA exchange coverage in states that use HealthCare.gov. They answer questions about health insurance, help people understand their plan and often assist in Medicaid enrollment or refer people to other services. They also raise awareness about the availability of exchange coverage through outreach and education programs.


Source: modernhealthcare.com

Liked Liked