Biden-Harris Admin makes largest investment ever in navigators ahead of 2023 Open Enrollment Period

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via the Centers for Medicare & Medicaid Services (CMS):

  • Historic investment of nearly $100 million builds on the Administration’s quadrupling of Navigators last year to help connect people to coverage

 The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is investing $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period to help consumers navigate enrollment through the Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP) and make health coverage more equitable and accessible to everyone.

These awards will enable Navigator organizations to retain staff and add to the more than 1,500 existing Navigators who were trained to help consumers find affordable, comprehensive health coverage in nearly every state and county during the 2022 open enrollment period. This follows a historic Open Enrollment Period in 2022 and is part of the Biden-Harris Administration’s efforts to enroll more people in health care coverage.

Today’s announcement marks the single largest Navigator funding award provided to date and serves as a continuation of historic levels of funding. The Biden-Harris Administration previously awarded $80 million to the program, quadrupling the number of Navigators for the 2022 Open Enrollment Period. More than 1,500 certified Navigators held more than 1,800 outreach and education events at accessible areas—such as local libraries, vaccination clinics, food drives, county fairs, and job fairs. This historic investment in outreach and enrollment efforts helped contribute to the record-breaking 14.5 million people who signed up for 2022 health care coverage through the Marketplaces, including nearly 6 million people who newly gained coverage.

Side note: Once again, I don't understand why CMS never includes the over one million people in New York and Minnesota who have enrolled in their Basic Health Plan programs. It's actually 15.5 million.

 “This is a historic investment to connect people to high-quality, affordable health care,” said HHS Secretary Xavier Becerra. “Last year, our investments helped result in the lowest uninsured rate in our nation’s history. This year, we’re doubling down on our efforts to ensure people get the insurance they need. Navigators critically help us reach people where they are, educating them on their health insurance options that can be lifesaving.”

 “Reaching people where they are is a key part of our strategy to connect people to health coverage. Navigators were incredibly effective during the last Open Enrollment period when a historic number of people signed up and now we are doubling down on investing in community Navigators who can help people find the coverage they need,” said CMS Administrator Chiquita Brooks-LaSure. “For those changing coverage or who struggle to afford health insurance, there are a variety of options to help.  The Health Insurance Marketplace and state-based Marketplaces can offer no-cost or low-cost coverage to millions of people.”

Navigators play a vital role in helping consumers prepare applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplaces, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators operate year-round increasing awareness among the remaining uninsured about the coverage options available to them, helping consumers find affordable coverage that meets their needs, and assisting consumers beyond the enrollment process to ensure they're equipped with the tools and resources needed to utilize and maintain their health coverage all year. Navigators must complete comprehensive federal Navigator training, criminal background checks, and state training and registration (when applicable), prior to assisting consumers.

The 2022 Navigator awardees will continue to focus on outreach to particularly underserved communities and includes $12.5 million to support additional direct outreach, education, and enrollment activities aimed at helping eligible individuals transition from Medicaid/CHIP to Marketplace coverage. Additional funds may be used for hiring additional Navigator staff to expand in-person services to more locations across their state, targeting outreach efforts in areas of high-need, and increasing enrollment assistance capacity through the use of virtual and telephonic appointments.

The transition help is particularly important due to the pending end of the formal Public Health Emergency, when millions of Medicaid enrollees will be kicked off of the program...whenever that ends up being...

Navigator organizations will focus on outreach to people who identify as racial and ethnic minorities, people in rural communities, the LGBTQ+ community, American Indians and Alaska Natives, refugee and immigrant communities, low-income families, pregnant women and new mothers, people with transportation or language barriers or lacking internet access, veterans, and small business owners. 

The 2022 Navigator awards are the second installment of a three-year period of performance agreement funded in 12-month increments known as budget periods. This multi-year funding structure is designed to provide greater consistency for Navigator awardee organizations, reducing yearly start-up time and allowing more efficient use of grant funds. 

The Biden-Harris Administration has worked tirelessly to expand access to health insurance and lower costs for America’s families, and thanks in part to these historic investments and unprecedented outreach efforts, the national uninsured rate has reached an all-time low of 8 percent under the Biden-Harris Administration. With the Inflation Reduction Act now signed into law, an estimated 13 million people will continue to save an average of $800 per year on their Marketplace health insurance, continuing the savings consumers received during 2021 and 2022 from President Biden’s American Rescue Plan.

 Marketplace Open Enrollment for the 2023 starts November 1, 2022 and ends January 15, 2023.