Navigators have been trying to do their work the past few years with shriveled government grants after the Trump administration sliced funding from $62.5 million a year to $10 million. Trump health officials contended that the enrollment helpers were not cost-effective and fostered few sign-ups — a view contrasting markedly with that of their successors in the Trump administration.
“Navigators play a key role,” the CMS announcement said, “in reaching underserved communities that historically have experienced lower access to health coverage.”
Still, the $2.3 million is “nowhere near what they need,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a health-policy research group, who focuses on health reform and consumer protections. She said federal rules constrain how much the government can quickly alter the existing financial agreements for the groups.
CMS said in its announcement that it intends to “increase funding significantly” for navigators for the regular ACA enrollment period that starts in the fall, without indicating the amount.
Jodi Ray, director of Florida Covering Kids and Families, the nation’s largest navigator organization, said Monday that the extra money for the three-month sign-up period underway “is not much” but will enable her group to hire some part-time navigators. She said the volume of calls for help are running about the same as during regular annual enrollment periods.
Allison Espeseth, director of Covering Wisconsin, that state’s only remaining navigator group, said, “We are thrilled they are making this happen, and it’s definitely needed,” though she noted the limits on quickly increasing such groups’ financial support.
“Is it enough?” Espeseth asked. “There’s a lot of work to be done in terms of regaining people’s awareness the marketplace still exists and is an option. . . . It’s going to take a lot more work.”
Espeseth said that in the two weeks since HealthCare.gov reopened, she has not seen in Wisconsin the marketing and advertisements Biden health officials have said would air to draw attention to the sign-up opportunity.
“It’s really quiet,” Espeseth said of the number of residents asking for help so far. Most consumers lately have been people who always have qualified to buy ACA health plans outside normal enrollment season, because they have had major changes in life circumstances that affect the coverage they need.
ACA health plans are for people who do not have access to affordable coverage through a job. The reopening of the federal marketplaces is happening in three dozen states that rely on HealthCare.gov. Many of the other states that run their own similar insurance marketplaces have also lengthened insurance-
buying opportunities. These decisions were prompted largely by the coronavirus pandemic, which set off powerful economic ripple effects that cost millions of Americans their jobs and accompanying health benefits.
The extra sign-up time also is an early manifestation of Biden’s goal of expanding insurance coverage in the United States, relying on the ACA to do so. The pandemic relief package passed by the House last week would include the first increase in premium subsidies for ACA health plans since the marketplaces began in 2014.
With such efforts underway, Pollitz said, “I just hope these [navigator] programs can hang on and get an actual funding increase that would be meaningful.”
