The Biden administration is providing funds to 60 Affordable Care Act navigator organizations for the 2022 plan year, up from 30 that received funding this year.
These organizations train and certify navigators who help consumers find coverage on the federally funded marketplaces.
The Centers for Medicare & Medicaid Services is providing $80 million in grant awards to 60 organizations with the aim of driving up the number of navigators to more than 1,500. The announcement comes two months before open enrollment begins on Nov. 1 for the 2022 coverage year.
The navigator organizations include community and consumer-focused nonprofits, faith-based organizations, trade and professional associations, hospitals and tribes or tribal organizations.
“Our local partners are crucial in helping people get covered,” said Department of Health and Human Services Secretary Xavier Becerra, in a news release. “By expanding our pool of navigators, we will reach more underserved communities, and grow our network of trusted experts who can help people across the country navigate their healthcare options.”
The 2021 navigator awards are for a 36-month period of performance, funded in 12-month increments.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
For the 2022 plan year, the grant awardees 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, among others. In fact, applicants were asked to detail their outreach and enrollment efforts to vulnerable populations.
The navigator program, which began in 2013, aims to help people gain access to health coverage options through the marketplace, Medicaid or the Children’s Health Insurance Program.
The program has seen some upheaval in recent years. The Trump administration cut funding for the navigator program from $63 million in 2016 to $10 million in 2020 and 2021.
But Biden’s CMS reversed this declining trend. Earlier this year, the agency announced $80 million in funding to ACA navigators for the 2022 plan year. A recent rule also reinstated previous requirements that navigators provide consumers with information and assistance on post-enrollment topics, such as the eligibility appeals process.
Enrollments on HealthCare.gov and state-based marketplaces have seen an upswing this year, with 2.5 million signing up for coverage during the 2021 special enrollment period, which ran from Feb. 15 to Aug. 15.
Further, as of March, a record high of nearly 81.7 million people were receiving coverage through Medicaid and CHIP.
Photo: Joe Raedle, Getty Images
