HHS Announces $60M to Help Consumers Navigate Marketplace Coverage

Courtesy HHS.gov

September 8, 2014

The Affordable Care Act is working for millions of Americans who are able to access quality health coverage at a price they can afford, in large part because of the efforts of in-person assisters in local communities across the nation.  People shopping for and enrolling in coverage through the Health Insurance Marketplace can get local help in a number of ways, including through Navigators. 

 Health and Human Services Secretary Sylvia M. Burwell announced $60 million in Navigator grant awards to 90 organizations in states with federally-facilitated and state partnership Marketplaces.  These awards support preparation and outreach activities in year two of Marketplace enrollment and build on lessons learned from last year.

"In-person assisters have an impact on the lives of so many Americans, helping individuals and families across the country access quality, affordable health coverage," said Secretary Burwell.  "We are committed to helping Americans get covered and stay covered with in-person assistance in their own communities."

According to a recent outside survey, a variety of assisters, including Navigators, in both state-based and federally-facilitated Marketplaces were responsible for helping an estimated 10.6 million consumers apply for coverage in Marketplace plans, Medicaid, or the Children's Health Insurance Program (CHIP) during the first Open Enrollment period.  Assisters tend to help those consumers in communities with the most challenging or complicated enrollments, and according to another poll, Latinos in particular valued the assistance of in-person help.  Navigators provide unbiased information to consumers about the Marketplace and other public programs in a way that recognizes the cultures of the communities they serve. Navigators were selected to receive these awards through a competitive grant process based on their ties with the communities they will be serving and other standards such as effectiveness and program integrity.

In addition to helping eligible individuals and their families enroll in coverage, Navigators help consumers compare their health coverage options including helping them determine whether they are eligible for public programs such as Medicaid and CHIP and guide consumers- many of whom have never had insurance before- on accessing and using their new coverage, among other important functions.

These awards build on lessons learned from the first year of Marketplace operations.

• Navigator grantees must maintain a physical presence in the Marketplace service-area, so that consumers can easily access face-to-face assistance.
• Navigator grantees are required to be trained on and comply with strict security and privacy standards to ensure that consumers' personally identifiable information (PII) is protected, as was the case last year. In no case will Navigators obtain a consumer's PII without the consumer's consent.
• In addition to quarterly and annual reporting, Navigators will also be required to submit to HHS weekly progress reports detailing their progress and activities in the communities they serve.
• Based on feedback from the assister community, HHS is incorporating new elements into this year's required training, such as a course on advanced Marketplace issues with detailed information on topics such as how to help college-age students enroll in coverage and re-enrollment.  HHS is committed to providing Navigators with on-going technical assistance and training opportunities throughout the year.

In addition to Navigators, Marketplaces make other resources available to consumers to help them access Marketplace coverage, such as certified application counselors, non-navigator assistance personnel (also known as in-person assisters), and agents and brokers. Consumers in federally-facilitated and state partnership Marketplaces can visit Find Local Help to find assistance in their area.

  Note of Interest:

Statement by HHS Secretary on CVS Ending Tobacco Sales

Courtesy HHS.gov

 We applaud CVS Health for becoming tobacco-free and ending the sale of cigarettes and tobacco products at its 7,700 CVS/pharmacy locations. CVS accomplished their goal one month ahead of their deadline of October 1.

 We also commend CVS Health on the launch of their national and personalized smoking cessation program.

CVS Heath's tobacco free policy is an unprecedented step in the retail industry, and will have an impact in bringing our country closer to achieving a tobacco-free generation, a call to action that we announced in January.

We hope others will follow CVS Health's lead in this important new step to curtail tobacco use.