HHS Allocates $60 Million to Assist Consumers on the Health Exchange

The Department of Health and Human Services (HHS) announced that $60 million in grant awards will be allocated to 90 organizations in states with federally-facilitated and state partnership insurance marketplaces in order to support preparation and outreach activities for the impending second year of open enrollment.

Under the Patient Protection and Affordable Care Act, individuals shopping for and enrolling in coverage through the health insurance marketplace can get local help in a number of ways, including through these newly funded Navigators. 

“In-person assisters have an impact on the lives of so many Americans, helping individuals and families across the country access quality, affordable health coverage,” said HHS Secretary Sylvia M. Burwell in a statement. “We are committed to helping Americans get covered and stay covered with in-person assistance in their own communities.”

According to a recent survey from the Kaiser Family Foundation, a variety of assisters, including Navigators, in both state-based and federally-facilitated marketplaces were responsible for helping an estimated 10.6 million consumers apply for coverage in marketplace plans, Medicaid, or the Children’s Health Insurance Program (CHIP) during the first year of open enrollment. Assisters tended to help consumers in communities with the most challenging or complicated enrollments, according to the study.

In addition, according to a poll from PerryUndem Research/Communications, Latinos in particular valued the assistance of in-person help. 

Navigators provide unbiased information to consumers about the marketplace and other public programs in a way that recognizes the cultures of the communities they serve. Navigators were selected to receive these awards through a competitive grant process based on their ties with the communities they will be serving and other standards such as effectiveness and program integrity.

In addition to helping eligible individuals and their families enroll in coverage, Navigators help consumers compare their health coverage options, including helping them determine whether they are eligible for public programs such as Medicaid and CHIP and guide these consumers on accessing and using their new coverage.

The grants were established by HHS based on what the agency learned after the first open enrollment period, including the following:

• Navigator grantees must maintain a physical presence in the marketplace service-area, so that consumers can easily access face-to-face assistance.
• Navigator grantees are required to be trained on and comply with strict security and privacy standards to ensure that consumers’ personal information is protected.
• In addition to quarterly and annual reporting, Navigators will also be required to submit to HHS weekly progress reports detailing their activities in the communities they serve.
• Based on feedback from the assister community, HHS is incorporating new elements into this year’s required training, such as a course on advanced marketplace issues with detailed information on topics such as how to help college-age students enroll in coverage and re-enrollment.

Consumers in federally-facilitated and state partnership marketplaces can find assistance by clicking here.—Kerri Fitzgerald