Navigators

CMS Logo

via CMS:

The Biden-Harris Administration is expanding the number of Navigator organizations to help people enroll in coverage through the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP) in 30 states with a Federally-Facilitated Marketplace. Through $80 million in grant awards for the 2022 plan year, 60 Navigator awardee organizations will be able to train and certify more than 1,500 Navigators to help uninsured consumers find affordable and comprehensive health coverage.

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CMS is targeting specific populations more closely in order to reduce racial healthcare coverage inequality:

Department of Health and Human Services (HHS) Secretary Xavier Becerra announced commitments from national organizations to support Black American outreach and enrollment efforts during the Special Enrollment Period (SEP) made available on HealthCare.gov by President Biden due to the COVID-19 Public Health Emergency. Black Americans represent roughly 13% of the U.S. population but 16% of the uninsured.

As part of the Black American Week of Action, April 25 – May 1, HHS and its partnership organizations will combine social media efforts to inform Black American consumers and spur enrollment in affordable, quality health plans through HealthCare.gov. An estimated 66% of Black uninsured adults now may have access to a zero-premium plan and 76% may be able to find a low-premium plan as a result of expanded coverage.

CMS Logo

This was actually announced last week, but I was mainly focused on the 2021 OEP enrollment report at the time:

Today, the U.S. Department of Health and Human Services (HHS) announced that to continue its efforts to increase access to enrollment assistance for consumers, the Centers for Medicare & Medicaid Services (CMS) will make $80 million available in grants to Navigators in Federal Marketplaces for the 2022 plan year. The funding, which will be used for outreach and education efforts, is the largest allocation CMS has made available for Navigator grants to date and represents an eight fold increase in funding from the previous year. CMS invested $10 million annually in the Navigator program beginning with funding awarded in 2018 for the 2019 plan year. CMS awarded $36.2 million in 2017 for the 2018 plan year, down from a high of $63 million awarded in 2016 for the 2017 plan year.

Here's an overview of the ACA's "Navigator" and "Certified Application Counselor (CAC)" programs:

Navigators

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 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.

Certified Application Counselors (CACs)

via the Nevada Health Link. This is from a couple of weeks ago, but still:

Nevada Health Link Announces Licensed Broker/Agent,
Navigator and In-Person Assister Recipients of Grant Program for Plan Year 2021

Carson City, Nev. –The Silver State Health Insurance Exchange (Exchange), the state agency that connects Nevadans to qualified health plans (QHPs) through the online State Based Exchange (SBE) known as Nevada Health Link, announces the licensed Brokers/Agents, Navigators and In-Person Assisters selected as part of its plan year 2021 grant program. The program is designed to help close the uninsured gap in Nevada by helping those on the frontline to more effectively market to uninsured and underinsured populations.

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.

via Covered California:

Covered California Announces Grants to Community-Based Organizations Across California in Preparation for 2020 and Beyond

  • Community-based organizations and clinics will receive a total of $6.3 million in grant funding to help people enroll in quality health care coverage.
  • The 105 organizations reflect California’s diversity and will target populations that are hard to reach, uninsured and eligible for financial help through Covered California.
  • Approximately 89 percent of Californians live within a 15-minute drive of these community-based organizations.

Covered California announced Friday that it intends to partner with 105 community-based organizations to educate consumers about their health care options, offer in-person enrollment and renewal assistance and provide ongoing support on how to get the best value from their health plan. The Navigator grants announced are part of Covered California’s ongoing commitment to support robust marketing and outreach, including working with trusted organizations throughout the state to help hard-to-reach people understand this new era of health care.

 

I don't know what the status is of H.R. 5155 (the House Democrats catch-all "ACA 2.0" bill which I've been pushing for awhile now), but it looks like individual elements of it are also in the works as standalone bills:

HEARING ON “STRENGTHENING OUR HEALTH CARE SYSTEM: LEGISLATION TO LOWER CONSUMER COSTS AND EXPAND ACCESS”

Date: Wednesday, March 6, 2019 - 10:00am
Location: 2123 Rayburn House Office Building
Subcommittees: Health (116th Congress)

The Health Subcommittee with hold a legislative hearing on Wednesday, March 6, at 10 am in the John D. Dingell Room, 2123 Rayburn House Office Building. The hearing is entitled, “Strengthening Our Health Care System: Legislation to Lower Consumer Costs and Expand Access.” The bills to be the subject of the legislative hearing are as follows.

As I noted back in July, in addition to the Trump Administration's Centers for Medicare & Medicaid (CMS) chopping down the marketing budget for HealthCare.Gov by 90% last year, they also slashed the navigator/personal outreach budget by over 40% as well, from $63 million down to $36 million...and this year have cut it by another $26 million, to just $10 million across all 34 states which rely on HealthCare.Gov to host their ACA exchange open enrollment functionality (there are 5 more states which are hosted by HC.gov, but which I believe operate their own exchange and navigator budget: Oregon, New Mexico, Nevada, Kentucky and Arkansas). Combined, that makes an 84% reduction in navigator funding over a 2 year period.

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