Administration distributing $98.9 million in Navigator grant funding – Healthcare Finance News

The Department of Health and Human Services is serving up $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period. The funds, which are being administered through the Centers for Medicare and Medicaid Services, are meant to help consumers navigate enrollment through the Marketplace, Medicaid, and the Children’s Health Insurance Program.
Open enrollment starts Tuesday, November 1, and ends on Thursday, December 15, for coverage that starts January 1, 2023.
The administration has framed the action as a means of advancing equity and accessibility in healthcare.
Ostensibly, the awards will enable Navigator organizations to retain staff and add to the more than 1,500 existing Navigators. They were trained to help consumers find affordable, comprehensive health coverage in nearly every state and county during the 2022 open enrollment period, said HHS.
The announcement marks the single largest Navigator funding award provided to date, the agency said. The Biden 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 have 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. The investment in outreach and enrollment efforts helped contribute to the record-high 14.5 million people who signed up for 2022 healthcare coverage through the marketplaces, including nearly 6 million people with newly gained coverage, HHS said.
Navigators play a 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.
They 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 use and maintain their health coverage all year.
Navigators must complete comprehensive federal training, criminal background checks and state training and registration, when applicable, prior to assisting consumers
The 2022 awardees will continue to focus on outreach to particularly underserved communities, and the program 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 telephone appointments.
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 awardee organizations, reducing yearly start-up time and allowing for a more efficient use of grant funds.
The administration has credited the investments and outreach efforts as one of the factors behind the low 8% uninsured rate in the U.S. 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, said HHS.
Twitter: @JELagasse
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