CMS Allocates Nearly $100 Million to Navigators For 2023 Open Enrollment

Aug. 30, 2022
HHS, through CMS, recently announced the investment of $98.9 million to 59 Navigator organizations to assist consumers in navigating enrollment through the Marketplace, Medicaid, and CHIP

On Aug. 26, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced via a press release the investment of $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period. The organizations aim to help consumers navigate enrollment through the Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP) and make health coverage more equitable and accessible. The funding will enable the Navigator organizations to not only retain staff but add to more than 1,500 Navigators who were trained on Healthcare.gov in almost every state and county during the 2022 enrollment period.

The release states that “Today’s announcement marks the single largest Navigator funding award provided to date and serves as a continuation of historic levels of funding. The Biden-Harris Administration previously awarded $80 million to the program, quadrupling the number of Navigators for the 2022 Open Enrollment Period. More than 1,500 certified Navigators held more than 1,800 outreach and education events at accessible areas—such as local libraries, vaccination clinics, food drives, county fairs, and job fairs. This historic investment in outreach and enrollment efforts helped contribute to the record-breaking 14.5 million people who signed up for 2022 health care coverage through the Marketplaces, including nearly 6 million people who newly gained coverage.”

Further, “Navigators play a vital role in helping consumers prepare applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplaces, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators operate year-round increasing awareness among the remaining uninsured about the coverage options available to them, helping consumers find affordable coverage that meets their needs, and assisting consumers beyond the enrollment process to ensure they're equipped with the tools and resources needed to utilize and maintain their health coverage all year. Navigators must complete comprehensive federal Navigator training, criminal background checks, and state training and registration (when applicable), prior to assisting consumers.”

The Navigator awardees from 2022 will still focus on outreach in underserved communities will receive $12.5 million to support additional direct outreach, education, and enrollment activities aimed at helping those eligible transition from Medicaid/CHIP to Marketplace coverage. Additional funds may be used for the hiring of additional Navigators and expanding in-person services.

“Navigator organizations will focus on outreach to people who identify as racial and ethnic minorities, people in rural communities, the LGBTQ+ community, American Indians and Alaska Natives, refugee and immigrant communities, low-income families, pregnant women and new mothers, people with transportation or language barriers or lacking internet access, veterans, and small business owners,” the release notes.

CMS Administrator Chiquita Brooks-LaSure was quoted in the release saying that “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. 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.”

Marketplace Open Enrollment for the 2023 starts November 1, 2022 and ends January 15, 2023.

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