Senate version of ENROLL act to repair the ACA Navigator program introduced w/21 cosponsors

Last month, the U.S. House of Representatives passed eight different healthcare-related bills. Three of them related to regulating prescription drugs and/or reducing drug prices; the other five composed about half of the dozen or so "ACA 2.0" bill package.

As a reminder, here's the eight bills which passed the full House:

H.R. 938, the "Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act of 2019," introduced by Reps. Kurt Schrader (D-OR) and Buddy Carter (R-GA), would discourage parking of 180-day exclusivity by a first generic applicant that is blocking the approval of other generics.

H.R. 1499, the "Protecting Consumer Access to Generic Drugs Act of 2019," introduced by Rep. Bobby Rush (D-IL), would make it illegal for brand-name and generic drug manufacturers to enter into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market.

H.R. 965, the "Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019," introduced by Reps. David Cicilline (D-RI), Jim Sensenbrenner (R-WI), Jerrold Nadler (D-NY), Doug Collins (R-GA), Peter Welch (D-VT), and David McKinley (R-WV), would establish a process by which generic manufacturers could obtain sufficient quantities of brand drug samples for testing thereby deterring gaming of safety protocols that brand manufacturers use to delay or impede generic entry.

H.R. 986, the “Protecting Americans with Preexisting Conditions Act of 2019,”introduced by Rep. Ann M. Kuster (D-NH), would require the Trump Administration to rescind the Section 1332 guidance of the ACA promulgated in October of 2018 that would undermine the law’s consumer protections.

H.R.1385, the “State Allowance for a Variety of Exchanges (SAVE) Act,” introduced by Reps. Andy Kim (D-NJ) and Brian Fitzpatrick (R-PA), would provide states with $200 million in federal funds to establish state-based Marketplaces. Under current law, federal funds are no longer available for states to set up state-based Marketplaces.

H.R. 1010, a bill to provide that the rule entitled “Short-Term, Limited Duration Insurance” shall have no force or effect, introduced by Rep. Kathy Castor (D-FL), would reverse the Trump Administration’s expansion of junk insurance plans, also known as short-term, limited-duration insurance plans.

H.R.1386, the “Expand Navigators’ Resources for Outreach, Learning, and Longevity (ENROLL) Act,” introduced by Rep. Kathy Castor (D-FL), would provide $100 million annually for the Federally-Facilitated Marketplace (FFM) navigator program. The bill would reinstate the requirement that there be at least two navigator entities in each state and would require HHS to ensure that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. The bill would also prohibit HHS from considering whether a navigator entity has demonstrated how it will provide information to individuals relating to association health plans or short-term, limited-duration insurance plans.

H.R. 987, the “Marketing and Outreach Restoration to Empower (MORE) Health Education Act of 2019,” introduced by Rep. Lisa Blunt Rochester (D-DE), would restore outreach and enrollment funding to assist consumers in signing up for health care, which has been slashed by the Trump Administration.

All of these are great bills. Unfortunately, passing the House is only the first phase...they also have to pass the Senate and then be signed into law by Donald Trump (or, alternately, they'd have to survive his veto via a 2/3 majority override vote in both the House and Senate). Needless to say, neither of those things are likely to happen.

That isn't stopping the Senate Democrats from trying, however. I don't know what's going on with the other seven bills, but they're taking a crack at at least one of them:


  • The Trump administration has slashed funding for health care enrollment assistance by more than 80 percent
  • ENROLL Act to restore funding for the Navigator program and help ensure that Americans have access to the affordable health care coverage they need

WASHINGTON, D.C. – U.S. Senators Tammy Baldwin (D-WI) and Bob Casey (D-PA), both members of the Senate Health, Education, Labor and Pensions (HELP) Committee, today introduced the Expand Navigators’ Resources for Outreach, Learning, and Longevity (ENROLL) Act to restore funding for the Navigator program that helps American families get the information and support they need to find a quality health care plan at a price they can afford. The House companion legislation passed as part of H.R. 987 last month, 234-183.

Navigators are essential to helping families, especially in rural, underserved communities, enroll in health care coverage that meets their needs. Unfortunately, since 2017 the Trump administration has slashed funding for the Navigator program by more than 80 percent. This is especially harmful to Americans in rural communities who already lack access to in-person assistance for shopping and enrolling in quality, affordable health insurance coverage.

“The Trump administration has spent the last two years sabotaging our health care system and as a result there are more Americans uninsured today than when President Trump took office. They have slashed funding for Navigator outreach efforts that help millions of Americans, including those in rural communities, sign up for quality health care coverage,” said Senator Baldwin. “Trusted Navigator programs like those in Wisconsin have had their funding cut by more than 80 percent in the past two years, meaning fewer people in Wisconsin have received the support they need to obtain affordable coverage. My legislation with Senator Casey will reverse these cuts to our Navigator programs and ensure that Wisconsinites, regardless of their zip code, can easily enroll in affordable health care coverage.”

“The current administration is doing everything in their power to keep Americans from accessing comprehensive, affordable health insurance,” said Senator Casey. “Navigators in Pennsylvania serve a critical function by providing unbiased assistance with health insurance enrollment. Often, they specialize in helping underserved or hard to reach populations that others cannot or will not help to enroll. The ENROLL Act will undo the administration’s attempt to undermine the Navigator program, and ensure that Navigators can continue to assist any American who needs help accessing private health insurance, Medicaid or CHIP.”

Since 2017, the Trump administration has repeatedly slashed funding for navigators, causing the level of Navigator services available in Wisconsin to diminish substantially. Covering Wisconsin and the Northwest Wisconsin Concentrated Employment Program, Inc., two of the state’s largest federally-certified and state-licensed Navigator agencies, lost significant federal support that has resulted in the end of in-person Navigator assistance in the Central Sands counties, the Fox Valley region, Kenosha and Racine County, and in rural southwestern, northern and western counties throughout Wisconsin.

More than one million Americans lost insurance coverage last year. As the sabotage of our health care system continues, the ENROLL Act would take action to support the Navigator program and ensure that hardworking families can find affordable coverage that works for them.

The ENROLL Act would:

  • Ensure that Navigators have the resources they need to assist Americans in finding affordable health care coverage and restore funding for the program to $100 million annually;
  • Promote efforts to ensure that Navigators provide public education and assistance that helps consumers, including those who may need extra help signing up, find coverage, rather than prioritizing application numbers;
  • Clarify that Navigator responsibilities include enrolling consumers in Medicaid and CHIP coverage;
  • Promote efforts to provide Americans with information on comprehensive health insurance that protects individuals with pre-existing conditions; and
  • Require that states have at least two Navigator programs with a physical presence in the state, including at least one community-based organization.

The ENROLL Act is supported by 64 leading health care organizations and advocacy groups around the country, including Covering Wisconsin, the American Heart Association, American Cancer Society Cancer Action Network, American Diabetes Association, American Lung Association, Arthritis Foundation, Epilepsy Foundation, National Multiple Sclerosis Society, Families USA, Planned Parenthood Federation of America, Asian & Pacific Islander American Health Forum, Young Invincibles, and more.

“Covering Wisconsin works to connect Wisconsin residents to health insurance and other programs that promote health, and promote their effective use of health insurance and health care. We very much appreciate Senator Baldwin’s work to advance quality, affordable health insurance, and her commitment to assuring that Wisconsin residents receive the outreach, education, and enrollment services needed to connect to such coverage,” said Allison Espeseth, Managing Director, Covering Wisconsin.

“Young Invincibles commends Senator Baldwin and the 20 co-sponsors who continue to fight for the restoration of the ACA’s Navigator program with the introduction of the ENROLL Act. As the leading organization focused on young adult health and a leader of the National Get Covered Coalition, we know expert, unbiased help is critical to ensuring everyone has access to coverage. Navigators specialize in reaching people with additional barriers to coverage, including young people, who may be brand new to the health insurance market and greatly benefit from enrollment help. This program is a vital piece of the ACA that we hope to see fully funded to ensure everyone can get the information they need to make an informed enrollment decision,” said Erin Hemlin, Health Policy & Advocacy Director of Young Invincibles.

“Appropriately funding health care navigators is essential for making sure consumers—especially those with complex medical conditions like cancer—can get access to the kind of coverage that meets their needs. We commend Senators Baldwin and Casey for acting to reverse the significant and damaging funding cuts that have been made in recent years and urge the Senate to pass this legislation quickly,” said Lisa Lacasse, President of the American Cancer Society Cancer Action Network.

“We proudly support the Expand Navigator’s Resources for Outreach, Learning, and Longevity (ENROLL) Act, which would restore access to services that help Americans enroll in high-quality health care. Navigators provide an important service to individuals across the country who are looking for health insurance that meets their individual needs. We are deeply concerned about the cuts to this program that have limited help for consumers to understand and select their best health care options. People with pre-existing conditions need access to adequate affordable health insurance. This legislation takes an important step to help all individuals find the plan that best supports their needs. We are grateful to Senators Baldwin and Casey for their leadership on this important issue,” said Nancy Brown, CEO of the American Heart Association.

“Cuts to navigators and outreach and enrollment activities since 2016 have taken away resources that help consumers understand and select healthcare coverage that’s the best fit for their healthcare needs,” said Harold P. Wimmer, National President and CEO of the American Lung Association. “As the result of the Administration expanding ‘skimpy’ plans that provide inadequate coverage for people with or at risk for lung disease, Senators Baldwin and Casey’s ENROLL Act is critically needed. The American Lung Association urges the Senate to pass this legislation so that uninsured individuals can make informed decisions that protect their health.”

“Everyone can agree on at least one thing about health insurance – it’s complicated,” said Bari Talente, Executive Vice President of Advocacy for the National MS Society. “People living with MS are not alone in needing experts to help them understand their health insurance options; someone who can cut through the jargon and clarify the costs. The ENROLL Act is needed to restore Marketplace Navigators to their proper role as expert, no-fee health insurance counselors in every state. This can reduce the likelihood of disastrous consequences when people unknowingly buy health insurance that doesn’t cover the medicines, services or equipment they need. That’s why the National MS Society supports Senator Baldwin and Casey’s ENROLL Act, and we thank them for their leadership on this issue.” 

“Rare disease patients rely on the Navigator program to ensure they enroll in the best plan possible for their unique situation. If enacted, this legislation would restore the resources necessary for the Navigator program to continue its integral work of educating individuals on health care coverage and enrollment,” said Peter Saltonstall, President and CEO of the National Organization for Rare Disorders.

“For the more vulnerable members of the psoriatic disease community, including but not limited to the elderly and those in rural areas, accessing the critical services provided by Navigators can make all the difference in ensuring they select a health plan that meets their individual needs. On behalf of the more than 8 million Americans living with psoriatic disease, we applaud Sen. Baldwin and Sen. Casey for introducing the ENROLL Act,” said Randy Beranek, President and CEO of the National Psoriasis Foundation.

“This legislation is badly needed to undo the harmful cuts made by this Administration to the Navigator Program. Navigators have served a critical role in enrolling Asian Americans, Native Hawaiians, and Pacific Islanders in health insurance, helping communities of color find the affordable health care they need. The Asian & Pacific Islander American Health Forum and our community partners have seen first-hand the harmful impacts these cuts have had on the populations we serve. I urge the Senate to follow the House in passing the ENROLL Act,” said Kathy Ko Chin, President and CEO of the Asian & Pacific Islander American Health Forum.

The ENROLL Act is also cosponsored by Senators Richard Blumenthal (D-CT), Cory Booker (D-NJ), Chris Coons (D-DE), Tammy Duckworth (D-IL), Kamala D. Harris (D-CA), Maggie Hassan (D-NH), Mazie K. Hirono (D-HI), Tim Kaine (D-VA), Angus King (I-ME), Amy Klobuchar (D-MN), Bob Menendez (D-NJ), Jeff Merkley (D-OR), Chris Murphy (D-CT), Gary Peters (D-MI), Jacky Rosen (D-NV), Jeanne Shaheen (D-NH), Tina Smith (D-MN), Debbie Stabenow (D-MI), Jon Tester (D-MT) and Chris Van Hollen (D-MD).