HHS, CMS Bump Affordable Care Act Marketplace Navigator Funding

The Biden administration announced a historic boost in funding for the Affordable Care Act marketplace Navigator program. 

The US Department of Health and Human Services (HHS) and CMS have set aside $98.9 million in grants for Navigator programs.

“Today’s announcement marks the single largest Navigator funding award provided to date and serves as a continuation of historic levels of funding,” the press release noted.

The funding will go toward Navigator activities such as direct outreach and enrollment support, particularly for historically underserved communities and individuals who could transfer their coverage from Medicaid to the Affordable Care Act marketplace.

“Reaching people where they are is a key part of our strategy to connect people to health coverage. 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,” said CMS Administrator Chiquita Brooks-LaSure. 

“For those changing coverage or who struggle to afford health insurance, there are a variety of options to help.  The Health Insurance Marketplace and state-based Marketplaces can offer no-cost or low-cost coverage to millions of people.”

The funds can also serve educational purposes. Navigator programs use local community cornerstones, such as libraries, county fairs, and food drives, to help educate underserved communities about the potential for finding healthcare coverage on the Affordable Care Act marketplace.

“Navigators critically help us reach people where they are, educating them on their health insurance options that can be lifesaving,” said HHS Secretary Xavier Becerra.

Additionally, Navigator programs may use the injection of federal dollars to expand their staff and their capacity

The previous year’s investment for the 2022 open enrollment season was $80 million, which was a historic investment in its own right at the time. As a result of this funding, Navigator programs quadrupled the number of Navigators and the share of individuals enrolled on the Affordable Care Act marketplace skyrocketed to 14.5 million, with 5.8 million new members. 

Additionally, in 2021, 1,800 events took place to spread awareness about open enrollment.

“This is a historic investment to connect people to high-quality, affordable health care,” said Becerra. “Last year, our investments helped result in the lowest uninsured rate in our nation’s history. This year, we’re doubling down on our efforts to ensure people get the insurance they need.”

The Biden and Trump administrations’ funding adjustments for the Navigator program often preceded changes in enrollment. After the Trump administration cut funding for the Navigator program, seven out of ten uninsured individuals did not seek out coverage due to financial barriers and a lack of awareness about subsidies, according to a Kaiser Family Foundation study.

Separate research showed that private companies did not step up to fill the outreach gap when the federal government cut navigator funding. While some Navigator programs were able to find supplemental funding elsewhere, counties that were hard hit by the Navigator funding cuts did not see a spike in privately or state-sponsored advertising for the open enrollment season.