Biden administration makes record-high investment in ACA navigators

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Dive Brief:

  • The Biden administration is pouring almost $100 million into organizations that help consumers navigate enrolling in Affordable Care Act plans for 2023, in the single largest navigator funding award to date.
  • The $98.9 million in grant funding will go to 59 returning navigator organizations to retain and add to the more than 1,500 existing staff that helped connect patients to coverage for the 2022 plan year.
  • Navigators will focus on outreach to underserved communities, the HHS said. Some $12.5 million of the funding is directed toward helping eligible people transition from Medicaid to marketplace plans, as looming state redeterminations are expected to boot millions off the safety-net coverage.

Dive Insight:

The Biden administration has made bolstering the ACA, especially in improving coverage for historically underserved populations, the foundation of its healthcare agenda.

Spurred by subsidies and special enrollment periods, a record 14.5 million Americans signed up for health insurance through the ACA exchanges for 2022 — the highest volume since the law was signed 12 years ago. That included 6 million consumers who were new to the exchanges, the Biden administration said.

President Joe Biden’s administration granted $80 million to navigators last year, renewing investment in a program that had been slashed by the Trump administration. In its last year, the Obama administration granted $63 million to navigators. However, the tranche was culled to $36 million in 2017 after President Donald Trump assumed office, and further cut to just $10 million annually between 2018 and 2020.

Navigators help consumers and small employers browse and select health coverage, prepare applications to establish eligibility for financial aid and refer consumers to assistance programs if needed. They also hold outreach and education events in local communities in a bid to educate consumers on their insurance options.

“Reaching people where they are is a key part of our strategy to connect people to health coverage,” CMS Administrator Chiquita Brooks-LaSure said in a statement on the funding. “Navigators were incredibly effective during the last Open Enrollment period when a historic number of people signed up and now we are doubling down on investing in community Navigators who can help people find the coverage they need.”

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