CMS Awards $100 Million to Marketplace Navigators

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CMS awarded $100 million in grants to 44 organizations dedicated to enrolling people in underserved and vulnerable communities in Affordable Care Act Marketplace health plans, according to a Monday news release published on its website. In 2024, these organizations, called Navigators, helped contribute to a historic 21.4 million Marketplace enrollments, up more than 77% from 2021. To encourage smaller-community based organizations to apply to become Navigators, CMS streamlined the application process this year.

These grants are part of a $500 million commitment to be released over five years, the longest grant period and biggest financial commitment to the Navigator program to date.

At-risk populations are identified by common social determinants of health such as geographic location, sexual identity and gender. Members of these communities are often at a higher risk of housing inequality, food instability and lack of employment. Recent data from the U.S. Department of Health and Human Services shows that by focusing on these communities, insurance rates are up.

Using census data from 2010 to 2022, uninsurance rates have dropped in the following communities:

• Black Americans: 20.9% to 10.8%
• Latinos: 32.7% to 18%
• Asian Americans, Native Hawaiians and Pacific Islanders: 16.6% to 6.2%
• American Indians and Alaska Natives: 32.4% to 19.9%

Navigators are vetted and trained by the CMS and their assistance is free to enrollees, whether someone is just exploring Marketplace options or is looking to sign up for a plan. They focus on individuals as well as small businesses. With Navigator’s help, four in five HealthCare.gov customers have been able to choose from coverage options that were $10 or less per month after subsidies.

Navigators can also assist people in helping enroll in or renew Medicaid and Children’s Health Insurance Program (CHIP) coverage

Examples of current Navigators include:

• Rural Health Project Inc. is a new Navigator that will target 12 rural counties in northwestern Oklahoma, which is home to one of the largest Marshall Islands populations in the United States.

• Choose Healthy Life uses a faith-based approach in 15 counties across South Carolina. They serve many uninsured Black communities. These organizations often have access to childcare and can provide emergency food assistance.

• Foundation Communities identifies low-income communities in an around Austin, Texas using census data. More than 10 counties are served and reached through food pantries, community health fairs and resident events at affordable housing properties.

• Community Care Network of Kansas provides statewide support with a focus on LGBTQ+ communities.

“Having access to trusted local partners is key to improving access to health services, particularly for those who just need a little extra help to understand the critical lifeline available through the ACA Marketplace and how to choose the best plan to meet their needs,” CMS Administrator Chiquita Brooks-LaSure said in the news release.

CMS has provided funding for Navigators since 2013.

Marketplace Open Enrollment begins on Nov. 1, 2024, and will last until at least Jan. 15, 2025, in some states. Enrollees interested in support can find assistance at Find Local Help. A full list of current Navigators is available here.