CMS Puts $2.3M Toward Navigator Funding for Special Enrollment

CMS will be offering $2.3 million in additional navigator funding for grantees in light of the special enrollment period, the agency announced by email.

“President Biden has made clear that every American deserves access to quality, affordable health care. Navigators help Americans understand their health insurance options, connecting consumers with financial help, and help them enroll in Marketplace plans, Medicaid, or CHIP,” said Jeff Wu, CMS Acting Deputy Administrator.

“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.”

There are 30 organizations that are eligible for this funding. These organizations are in 28 federally-facilitated marketplace (FFM) states.

While the announcement outlined general ways in which this funding can be put to use, the agency noted that the organizations have some freedom in deciding where the funds are most needed. Navigator programs already submitted their budgets for the 2020 to 2021 timeframe, but CMS will accept another set of plans and budget projections for this new funding.

The agency indicated that this is only the first step in providing financial support for these groups.

“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 (NOFO) grants to facilitate a robust applicant pool and increase access to assistance for consumers in the future,” the announcement stated.

The NOFO will be published this spring. The current grants will end on August 29, 2021.

This announcement stands in stark contrast to the previous administration’s stance towards Navigator programs.

Under the Trump administration, CMS sought to rely more heavily on independent agents and brokers. These entities were more cost effective, CMS argued. The agency cut navigator funding, arguing that navigators received $36 million in federal funding but only enrolled approximately one percent of the federal health insurance marketplace enrollees.

The decision drew critique from the Government Accountability Office (GAO). Although the move may have led to less spending going toward navigators, GAO’s report indicated that it led to a decline in individual health insurance marketplace enrollment due to consumer confusion.

The Biden administration has stated its intent to bolster the Affordable Care Act. In the executive order that established the special enrollment period, the administration directed federal agencies and departments to review any regulation that may undercut the Affordable Care Act or Medicaid.