Public Payers News

CMS Announces Historic Navigator Grant Funding for 2022-2024

CMS will provide $80 million total in Navigator grant funding which the agency hopes will bolster organizations’ outreach to underserved populations.

Social Determinants of Health, CMS, CHIP, Medicare, Medicaid, Affordable Care Act

Source: CMS Logo

By Kelsey Waddill

- A significant amount of Navigator grant funding is available for Navigator organizations to help employ more individuals to guide Americans through the 2022 plan year, CMS announced.

“Our local partners are crucial in helping people get covered. By expanding our pool of Navigators, we will reach more underserved communities, and grow our network of trusted experts who can help people across the country navigate their health care options,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra.

In what Secretary Becerra called a historic investment, CMS is offering $80 million in grants for the 2022 plan year to 60 eligible organizations. These organizations are spread out across the 30 states that are on the federally-facilitated marketplaces. Navigator organizations come in a variety of types including faith-based organizations, hospitals, and tribal organizations.

Due to this investment, the 60 Navigator organizations will be able to hire 1,500 Navigators for plan year 2022. As part of the grant, the Navigator organizations are charged with targeting certain communities that traditionally do not have easy access to healthcare coverage.

For example, Navigator organizations may centralize their efforts around the LGBTQ+ population in their regions, refugee and immigrant communities, veterans—six percent of whom were uninsured in 2019—, or small business owners who struggle to afford healthcare coverage for their employees. 

The organizations may also target groups that regularly experience particular social determinants of health barriers. Some of the grantees may use the funds to boost outreach to residents in need of transportation. Language barriers can prevent individuals from accessing care, so some of the grant funds may increase Navigator programs’ bilingual capabilities.

Other grantees will target potential enrollees with specific conditions. A set of Alabama Navigator organizations will put some of their funding towards reaching out to uninsured individuals with HIV. Multiple states’ organizations are setting aside some funds to target individuals with mental and physical disabilities.

“Local health coverage experts have worked hard to build relationships and trust in the communities in which they serve. These Navigators consistently help consumers understand their options, helping with potential language and other barriers, so they can find health coverage that best fits their needs,” said CMS Administrator Chiquita Brooks-LaSure. 

“With this additional grant funding, even more Navigators will be able to provide comprehensive assistance through customized educational and outreach activities, especially to underserved communities.”

The grants will provide the organizations with funding for a total of three years. CMS will distribute the funds on a yearly basis.

“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,” CMS explained.

This grant announcement syncs with the Biden-Harris administration’s plan to bolster the Affordable Care Act marketplace as a tool to combat uninsurance. The American Benefits Council predicted in 2020 that the new administration would focus on expanding and building on the Affordable Care Act.

Almost as soon as the Biden administration took office, patient Navigators called on the president to boost funding to Navigator programs. The infusion of funding for Navigators may have helped pave the way for a strong special enrollment period.

Navigators serve a variety of roles as they support Americans’ healthcare coverage decision-making processes. These programs provide free, neutral guidance to Americans who are looking for coverage through the Affordable Care Act marketplace, Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP).

During an open enrollment period, Navigator offices can receive hundreds of phone calls as Americans try to navigate all of their coverage options. These organizations provide patient advocacy and patient education in a complex system.