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CMS gives $2.3 million in additional Navigator funding for ACA special enrollment period

Navigators reach underserved communities that historically have experienced lower access to health coverage, CMS says.

Susan Morse, Managing Editor

In contrast to cuts made during the Trump Administration, the Biden Administration is increasing funding for the Navigator program to help consumers enroll in the Affordable Care Act during the special enrollment period.
 
The Centers for Medicare and Medicaid Services is making approximately $2.3 million in additional funding available to current Navigator grantees in federally-facilitated marketplace states to support outreach, education and enrollment efforts around the 2021 special enrollment period set by the Biden Administration. 

The ACA is open for consumers to enroll through May 15. 

Thirty organizations across 28 states are eligible to receive these funds to help consumers access financial assistance through HealthCare.gov, complete their applications and enroll in coverage through the marketplace, Medicaid, or the Children's Health Insurance Program.

Navigators play a key role in reaching underserved communities that historically have experienced lower access to health coverage and greater disparities in health outcomes, CMS said. The additional resources announced today will provide vital support and resources to these communities.

WHY THIS MATTERS

Under the Trump Administration, CMS cut Navigator funding as the administration also supported a lawsuit by Republican states before the Supreme Court to deem President Barack Obama's signature law unconstitutional.

That case is pending a decision by the justices before the end of the June term.

In August 2020, CMS awarded $10 million in Navigator grants to 30 returning organizations, matching the annual level of funding that was awarded over the last two years.

The organizations also got $10 million in 2019. This represented a decrease from the $36 million awarded by CMS in 2018.

Navigator representatives interviewed at the time said they received cuts of up to 75% in federal funding. They helped consumers beyond open enrollment, they said, answering requests for those who said they never received an insurance card or who asked for information on finding a doctor or about drug coverage.

The special open enrollment period is aimed at getting health insurance coverage for those who lost their jobs due to the COVID-19 pandemic. 

THE LARGER TREND 

Navigator organizations can determine how best to use the additional funding made available by CMS based on their previously approved plans and current needs. CMS will review all updated plans and budget documentation that outline how Navigators plan to use the additional funding to enhance their previously approved program operations for the remainder of the 2020-2021 budget period.
 
CMS will invest in the future of the Navigator program this year, and plans to increase funding significantly for the upcoming 2021 Navigator Notice of Funding Opportunity grants to facilitate a robust applicant pool and increase access to assistance for consumers in the future. 

CMS plans to publish the notice this spring to allow sufficient time to award a new round of Navigator grants in advance of Open Enrollment for the 2022 plan year. The current 2020 Navigator grant runs through August 29.

ON THE RECORD

"President Biden has made clear that every American deserves access to quality, affordable health care," said Jeff Wu, CMS acting deputy administrator.

"Navigators help Americans understand their health insurance options, connecting consumers with financial help, and help them enroll in Marketplace plans, Medicaid, or CHIP. During a public health emergency, it is critical for consumers to have access to assistance with finding affordable, comprehensive health coverage that best fits their needs."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com