HHS to Spend $10M on Affordable Care Act Navigator Program

September 05, 2017 - HHS and CMS announced that they will allocate $10 million to support the Affordable Care Act Navigator program, which helps health insurance consumers find coverage solutions during the Open Enrollment period.

Launched in 2013, the Navigator program was intended to engage consumers and provide them with information and educational outreach concerning the new health insurance exchanges. Since its first year, the Navigator program has helped 9 million consumers learn about their options for exchange coverage.

Randy Pate, Director, Center for Consumer Information & Insurance Oversight announced that CMS will direct the $10 million towards digital media, email, and text messages.

“Outreach will also be targeted based on specific demographic and geographic data. This approach is not only based on previous evaluation of past Exchange outreach efforts, but is also consistent with promotional spending on Medicare Advantage and Medicare Part D,” Pate said.

Navigator program funding is generated from user fees paid by payers participating in the federally-facilitated exchange. During the previous enrollment period, Navigators received over $62.5 million in federal grants while enrolling 81,426 individuals.

This year, CMS will institute funding measures that provide Navigators grantees federal monies based on their ability to meet their enrollment goals during the previous year.

“For example, a grantee that achieved 100 percent of its enrollment goal for plan year 2017 will receive the same level of funding as last year, while a grantee that enrolled only 70 percent of its enrollment goal would receive 70 percent of its previous year funding level, a reduction of 30 percent,” said Pate. “The new funding formula will ensure accountability within the Navigator program.”

In this final year of a three-year funding cycle, Navigators will assist consumers with plan selections, and have specific focus on consumers who are currently enrolled in coverage areas where issuers have reduced or eliminated federal plan offerings.

In addition, Navigators will be asked to focus outreach efforts to inform consumers regarding the new Open Enrollment dates for the upcoming 2018 coverage year, which runs from November 1 to December 15, 2017.