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Thursday, September 11, 2014

Navigator Grants Awarded to Meet Goals of Second Open Enrollment

This is blog is part of our Countdown to Open Enrollment campaign. Visit our Enrollment Assister Resource Center for information to help navigators and assisters.

In its second round of navigator grants, announced on Monday, the Department of Health and Human Services (HHS) awarded a total of $60 million to organizations in the 34 states where the federal government operates the health insurance marketplace. Of the 90 organizations receiving funding, 61 are returning for a second year of outreach and enrollment assistance.

These grants support the crucial work community-based organizations do to educate consumers about their health insurance options, like helping them sign up for or renew a marketplace health insurance plan. They also help consumers troubleshoot problems with their applications and with their health coverage throughout the year. These navigators and navigator-based organizations offer unparalleled assistance to consumers before, during, and after the open enrollment season.

Navigators will play an even more essential role in the second open enrollment period

In the first open enrollment period, navigators assisted more than 10 million people. Through face-to-face interactions, navigators were able to simplify and humanize a process that many consumers found very complex.

This help will be equally essential during the second open enrollment period. Consumers will need help with understanding changes in their health insurance plans or with choosing new plans that may better meet their family’s needs. In addition, many consumers will have more in-depth questions about the plans available in the marketplace going into their second year of coverage than they did in the first year, as they have more information about how differences among insurance plans may affect their access to care.

Navigators will be more crucial than ever, given the unique challenges of the second open enrollment period. Some of these challenges include:

  • Many of the more than 8 million consumers who are already enrolled in coverage will seek assistance as they renew their coverage for next year.
  • Those who have not yet enrolled likely belong to hard-to-reach groups. These include consumers in rural areas and communities of color. Navigators who focus on specific communities will need to invest time in developing materials and holding events that are culturally sensitive in order to increase enrollment among consumers who face ongoing barriers to coverage.
  • The open enrollment period will be half as long, requiring consumers to shop and make important insurance decisions in much less time.

Navigators must accomplish more in the second open enrollment period with less funding

Navigators will have more to do during the second open enrollment period, but they will be doing it with fewer resources. Funding for navigators in federally facilitated marketplace states has declined from $67 million in 2013-2014 to $60 million for 2014-2015.

In some cases, private charitable funding will supplement federal funding, but altogether, there are likely to be fewer resources supporting enrollment assistance in the next year than there were in the last year. And while the next open enrollment period will be only half as long as the initial open enrollment period, assisters will need to help more people in a more complicated environment in much less time. Navigators will need to be efficient, and navigator programs must be prepared to streamline the process to help staff with limited resources meet as much of the demand as possible.

To learn how to get the most out of limited resources, read the Georgetown University Health Policy Institute’s blog about how, with limited government resources, navigators are filling the void for consumers. And check out Families USA’s brief about how volunteers can help add capacity for enrollment assistance programs.

Building on last year’s success will pave the way for a second effective open enrollment

The good news is that most of the funded navigator organizations are not starting from scratch. They have a year of experience to build on: an existing infrastructure, tested tools and materials, and an established partnership network to maximize capacity.

HHS has also released a new training curriculum for assisters, which adds training on complex topics such as immigration and income issues. HHS is also improving the healthcare.gov website, which will hopefully make the consumer application and renewal experience run more smoothly. And most consumers who sought help from a navigator in the last year will be able to go back to that same trusted source for any help they need this year.

Navigators will be busy over the next year, helping consumers enroll in and renew coverage during the upcoming open enrollment period, helping consumers with special enrollment, and assisting consumers with health coverage problems they experience throughout the year. They’ll also play a key role in educating consumers about how health insurance works and how to use it appropriately. Continuing to increase enrollment in health insurance programs will not be easy, but having navigators in place in communities around the country is a critical element for success.