- Navigators and In-Person Assistors: State Policy and Program Design Considerations
- Designing Consumer Assistance Programs
ACA Marketplace Navigators and Assisters
The Affordable Care Act became law more than three years ago, but polls find that the majority of Americans still do not understand the law and how it will affect them. A centerpiece of the law—health insurance exchanges or marketplaces—are now open to consumers. The marketplaces, run by either states or the federal government, allow people to shop for insurance, find out whether they qualify for federal subsidies, and enroll in a health plan.
Educating people about the marketplaces and helping them understand their insurance options will require a massive outreach effort carried out in part by navigators and non-navigator assisters (also called in-person assisters or, more simply, assisters). The troublesome launch of the marketplaces, in which most people could not shop online, highlights the importance of consumer assistance in getting people enrolled.
People who are frustrated with the online marketplace can turn to navigators and assisters to walk them through the process. Navigators are individuals or community-based organizations funded by federal or state grants to help guide consumers in the marketplace, assist with subsidy applications, and enroll in a health plan. Assisters perform many of the same functions as navigators, but they are funded by separate grants or contracts administered by states. A third category of enrollment assisters, certified application counselors, will help people fill out applications and compare health plans but do not receive federal funding through the marketplaces.
Navigators and assisters are key components in the success of the marketplaces. With the rough launch of the marketplaces making it difficult for people to shop for plans and enroll online, navigators and assisters are more important than ever. Much of the job educating and enrolling people will be on a one-on-one basis, a time-intensive and costly effort that will be more difficult in states that are hostile to the law.
In addition to navigators and assisters, HHS is relying in part on not-for-profit organizations that have pledged to provide outreach and education on the Affordable Care Act. More than 100 organizations have signed on as Champions for Coverage, including the American Hospital Association, Families USA, and Enroll America.