Navigators to Play Critical Role in Healthcare Exchange Marketplaces

A recent press release from the Centers for Medicare & Medicaid Services (CMS) revealed the group’s intention to recruit “Navigators” in assisting consumers with the new healthcare exchanges, especially as October enrollment dates quickly approach.

According to the CMS, a $54 million grant will aid in training hired volunteers, all of whom will be made available to consumers seeking health insurance through federally-facilitated and State Partnership Marketplaces. As qualified, unbiased educators, these Navigators will answer buyer questions and only be permitted to make impartial suggestions, not decisions, for consumers.

Acting CMS Administrator Maryiln Tavenner stated that, “Navigators will be an important resource for consumers who want to learn about and apply for coverage in the new Marketplace.”

Future guides do not have to be licensed agents or brokers, says Jonathan Block of Modern Healthcare. However, these Navigators are prohibited from being employees of insurers or from receiving compensation from carriers, in order to avoid conflicts of interest. Nevertheless, Paul Bedard of the Washington Examiner found that compensation or guidelines for becoming a Navigator will likely not be a concern for volunteers. In addition to non-English speaking Navigators having access to translators, some early pay estimates for these exchange employees range anywhere from $20 to $48 an hour.

If these Navigators are effective in their anticipated outreach, they may surpass the Congressional Budget Office’s (CBO) forecast of eligible recruits, according to

of the

. Currently the CBO estimates that 30 million people will remain uninsured in 2022, so the success of these Navigators could be the difference between meeting or exceeding Obamacare coverage targets.

The Navigator grant is only “a drop in the bucket” in enrolling millions of uninsured Americans into health insurance coverage, said Stan Dorn, senior fellow at the Urban institute. Conversely, Laura Goodhue, executive director of Florida CHAIN said this so-called drop “will significantly assist community based groups who are closest to serving the needs of the uninsured with the task of educating and enrolling millions of people in a short time period."

Although the Affordable Care Act mandates healthcare coverage for Americans nationwide, the grants will be limited only to those states using federally-run exchanges.

Around the Web

CMS Proposes Help for Consumers Navigating the Health Insurance Marketplace [The Centers for Medicare & Medicaid Services]

HHS Sets Course for Exchange 'Navigators' [Modern Healthcare]

Tens of Thousands Obamacare 'Navigators' to be Hired [The Washington Examiner]

Funding to Enroll Uninsured in New Markets Called 'Drop in Bucket' [Kaiser Health News]

Sarah Kliff Washington Post