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$100 Million Being Awarded to ACA Navigators to Help Boost Enrollment

Insurance Forums Staff

The Biden-Harris Administration recently announced it is awarding a new round of $100 million to organizations it says are vital to helping underserved communities, consumers and small businesses find and enroll in health care coverage through HealthCare.gov, the Health Insurance Marketplace.

The Centers for Medicare & Medicaid Services (CMS) is awarding the grants in advance of this year’s Marketplace Open Enrollment (which begins Nov. 1, 2024) to 44 Navigator grantees in states using HealthCare.gov.

The grants are part of a commitment of up to $500 million over five years—the longest grant period and financial commitment to date, and what CMS calls a “critical boost” for recruiting trusted local organizations to better connect with those who often face barriers to obtaining health care coverage.

“We are committed to ensuring that all communities and individuals are connected to affordable, high-quality health coverage. And to help make that possible, we are making the single largest investment ever in the history of the Navigator program,” said HHS Secretary Xavier Becerra, in an Aug. 26 press release. “Under President Biden and Vice President Harris, Navigators have helped educate and enroll millions in quality coverage, contributing to the lowest uninsurance rate in our nation’s history, including record enrollments in communities often left behind. HHS will continue to double down on our efforts so we can reach people where they are, increase coverage, and save lives.”

The goal of the grants is to help ensure the millions who still need coverage know affordable options are available, added CMS Administrator Chiquita Brooks-LaSure.

“Having access to trusted local partners is key to improving access to health services, particularly for those who just need a little extra help to understand the critical lifeline available through the ACA Marketplace and how to choose the best plan to meet their needs,” Brooks-LaSure said.

Navigators offer free assistance to people exploring health coverage options through HealthCare.gov, from reviewing available plans to assisting with eligibility and enrollment forms, and post-enrollment services such as using their coverage to get care. Navigators can also assist people in helping enroll in or renew Medicaid and Children’s Health Insurance Program (CHIP) coverage.

During the plan year 2024 Marketplace Open Enrollment Period, a 21.4 million people selected health care plans through HealthCare.gov and state-based marketplaces, including with the help of Navigators. Overall, the release said four in five HealthCare.gov customers were able to select from health care coverage options that were $10 or less per month after subsidies.

To encourage smaller community-based organizations to become Navigators, CMS streamlined and simplified the application process this year. CMS also continues to advance critical requirements that Navigators focus their outreach on key underserved groups that have accounted for more than 20% of Marketplace enrollees in recent years. These groups include racial and ethnic minorities; rural communities; the lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual, plus (LGBTQIA+) communities; refugees; immigrants; families with low income; pregnant and expectant parents; and those who lack transportation, internet access, or English-language proficiency.

For example:

Rural Health Project, Inc., is a new Navigator grantee that will target 12 rural counties in northwestern Oklahoma—home to one of the largest U.S. populations of citizens from the Marshall Islands. By providing language support in Marshallese, Rural Health Project is one of several Navigator groups working to improve the quality and cultural competency of Navigator services.

• New Navigator grantee Choose Healthy Life will employ a faith-based approach to target 15 counties across South Carolina, many representing Black and African American communities that remain uninsured. Faith-based groups benefit from high levels of trust among community members, and often provide wrap-around services that can address barriers to enrollment, such as childcare, emergency food assistance, and access to other social services.

Foundation Communities, a returning Navigator organization, uses Census data to identify communities in and around Austin, Texas, that can benefit from assistance enrolling in health care coverage. These often include people with low incomes, as well as racial and ethnic minorities across more than 10 counties. Foundation Communities leverages its research to conduct focused outreach and education, particularly at community health fairs, food pantries, and resident events in affordable housing properties.

To learn more about this year’s Navigator grantees, visit https://www.cms.gov/marketplace/in-person-assisters/programs-procedures/in-person-assistance – Navigators.

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