CMS awards $67M in navigator grants for public exchange

The Centers for Medicare and Medicaid Services has issued $67 million in grant awards to fund navigators on the public exchanges for 2016 open enrollment.

The grants were awarded to 100 organizations in 34 states that operate federally facilitated marketplaces, state partnership marketplaces and supported state-based marketplaces, CMS said Wednesday.

In 2014, the Department of Health and Human Services provided $60 million in navigator grant awards to 90 organizations in states with federally-facilitated and state partnership marketplaces. 

For open enrollment for plan year 2016, 67 organizations are returning grantees, “providing stability and continuity for many consumers who have come to rely on the assistance offered by these navigator grantees both for enrollment and post-enrollment concerns,” CMS said in statement.

For this year’s open enrollment, which begins November 1, grantees will expand access to local help in many states, CMS says.  In Illinois, Indiana, Iowa, Montana, New Jersey, West Virginia and Wisconsin, more counties will be covered by navigator entities during the marketplace’s third open enrollment period compared to the second open enrollment.  In West Virginia alone, an additional 42 counties will be covered.

Also see:  California exchange awards navigator grants, lauds agents

 “There are a lot of choices when it comes to signing up for health insurance and we want to help make sure consumers feel confident that they’ve picked the right plan,” says Kevin Counihan, CEO of the health insurance marketplaces. "In-person assistance from navigators and assisters has proven to be an incredibly important avenue for consumers to get the right coverage. I'm pleased that navigators and assisters will be available in even more geographic areas this year."

Navigators and assisters are trained specialists who provide consumers in their communities with in-person help, answering their questions about their health insurance and financial assistance options and assisting them as they complete their application.

In response to an inquiry about a broker’s role, a CMS official says that “to the extent permitted by states, agents and brokers play an important role in educating consumers about marketplaces and insurance affordability programs, and helping consumers receive eligibility determinations, apply for premium tax credits and cost-sharing reductions, compare plans, and enroll in coverage.”

With this award, CMS is expanding its commitment to provide in-person assistance, and this comes after the announcement of some significant funding to support enrollment in community health centers, explains Katherine Hempstead, a director at the Robert Wood Johnson Foundation.

Also see: Maryland to transfer state-run exchange calls to brokers

“There is also an increased use of brokers throughout the states, and some very innovative ways to connect consumers to various types of personal assistance, both in the state exchanges and through non-profit organizations such as Enroll America,” she says. “This is in addition to major improvements in all exchange platforms and a greatly increased supply of high quality decision support tools. By all appearances, the infrastructure of consumer assistance will be at an all-time high for this third open enrollment period.”   

Anne Filipic, president of Enroll America, a pro Affordable Care Act health care enrollment coalition, says this announcement is “great news for consumers and a big step toward making sure in-person assistance is available in every community.”

“The next Affordable Care Act open enrollment period begins in November, and access to free in-person assistance remains critical to enrollment success, especially since more than 70% of the remaining uninsured think it’s important to talk to someone one-on-one when buying insurance,” she adds.

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