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CMS issues 2020 federally-facilitated exchange Navigator awards

Today, the Centers for Medicare and Medicaid Services awarded $10 million in Navigator grants to 30 returning organizations, matching the annual level of funding that was awarded over the last two years.

Each year, CMS awards Navigator Cooperative Agreement grants to organizations that serve as Navigators in federally-facilitated exchange states. Navigators offer assistance to consumers shopping for and enrolling in health coverage on the Federal Health Insurance Exchange.They also provide outreach and education to raise awareness about the Federal Health Insurance Exchange.

Navigators are part of a wide array of options for consumers seeking assistance with enrolling in health coverage, including the Exchange Call Center, Certified Application Counselors, and agents and brokers that can help consumers.

The 2019 Navigator awards were made for a 24-month period of performance, funded in two 12-month increments known as budget periods. The grants awarded today are for the second 12-month budget period. The 2021 Open Enrollment Period for the Federal Health Insurance Exchange is November 1 to December 15.

WHAT’S THE IMPACT

According to CMS, Navigators play a vital role in helping consumers prepare applications to establish eligibility and enroll in coverage through the Marketplaces, and potentially qualify for insurance affordability programs.

They also provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary.

Navigators are funded through federal grant funds and must complete comprehensive federal Navigator training, criminal background checks, and state training and registration (when applicable) prior to assisting consumers.

Entities and individuals can’t serve as Navigators in the federally-facilitated Marketplaces without receiving federal grant funding from CMS to perform Navigator duties.

Among the recipients are United Way of Anchorage in Alaska; Westside Family Healthcare in Delaware; the Georgia Association for Primary Health Care; Legal Aid Society Hawaii; Heartland Community Health Clinic in Illinois; Arab Community Center for Economic and Social Services in Michigan; First Choice Services in Montana and New Hampshire; Legal Aid of North Carolina and Oklahoma; Change Happens in Texas; and Memorial Hospital of Laramie County/Cheyenne Regional in Wyoming.

A complete list can be found here.

THE LARGER TREND

Under the Trump Administration, Navigator funding has been cut.

In 2018, CMS decreased the amount of Navigator funding for the Affordable Care Act from $36 million to $10 million for 2019.

The prior year, Navigator representatives interviewed said they received cuts of up to 75% in federal funding. They helped consumers beyond open enrollment, they said, answering requests for those who said they never received an insurance card or who asked for information on finding a doctor or about drug coverage.

CMS Administrator Seema Verma said at the time that it was time for the program to evolve.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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