Navigating the Health Insurance Landscape

written by Nicholas L. Cavarocchi, Jr.

What's Next for Navigators, In-Person Assisters and Brokers?

Even though the Affordable Care Act (ACA)  became law in 2011, the majority of Americans still do not understand the law and how it will affect them, which makes the work of local in-person assisters in US communities key to Americans accessing new quality health coverage.  Health insurance exchanges or marketplaces are a centerpiece of the law and now open to consumers.  These marketplaces, run by either the 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. As we enter the next open enrollment period, beginning November 15, people shopping for and enrolling in coverage through the Health Insurance Marketplace can get local help in a number of ways, including through Navigators. 

States have taken different approaches to implementing the ACA and have had varied enrollment experiences to this date.  Four states – Colorado, Connecticut, Kentucky, and Washington – established a state-based marketplace, implemented the ACA’s Medicaid expansion, and achieved success enrolling eligible individuals into coverage. 

Broad marketing campaigns in all four states raised public awareness of new coverage options.  Local level outreach and enrollment efforts played a pivotal role in educating consumers and encouraging them to enroll into coverage.   

US Department of Health and Human Services Secretary Sylvia M. Burwell has announced $60 million in Navigator grant awards to 90 organizations in states with federally-facilitated and state partnership Marketplaces.  The awards support preparation and outreach activities and will fund in-person assistance that people will receive as they shop for exchange plans in the fall.  She described in-person assisters as “having an impact on the lives of so many Americans by helping them and their families gain access to the health coverage they need at an affordable price.  We are committed to helping Americans get covered and stay covered with in-person assistance in their own communities,” said Burwell.

In addition to helping eligible individuals and their families enroll in coverage, Navigators help consumers compare their health coverage options to see what public programs they are eligible for such as Medicaid or the Children’s Health Insurance Program (CHIP).  Whether an individual applies directly to Medicaid or through a Marketplace, he or she is to be enrolled in the program for which he or she is eligible.  To implement these new processes, many states have needed to make significant upgrades to antiquated Medicaid enrollment systems or build new systems. 

Contact information for local assisters can be found at https://localhelp.healthcare.gov/ (for the Federally-Facilitated marketplace states) or via the websites of state-based marketplaces.

Even though creation of exchanges have been difficult across the country, some states are making a concerted effort to make them work and the success of these states may result in other states making the same effort thus fully implementing ACA.

Lisa Ellington

Big Thinkery, LLC, 1011 Kenilworth Court Northwest, Concord, NC, 28027