CMS to devote nearly $100M to ACA navigators for 2023 open enrollment

The Biden administration is investing $98.9 million in grant funding to 59 returning Navigator organizations that assist consumers in picking an Affordable Care Act (ACA) exchange plan. 

The grant funding, announced Friday by the Centers for Medicare & Medicaid Services (CMS), is the largest investment the federal government has made to date in the Navigator program. CMS officials said the funding can be used to add to more than 1,500 existing Navigators ahead of ACA open enrollment that starts Nov. 1. 

“The Biden-Harris administration is further strengthening its efforts to enroll more people into healthcare coverage,” CMS Administrator Chiquita Brooks-LaSure told reporters during a call Friday. 

Navigator organizations have worked to assist consumers and raise awareness about ACA coverage options and steer patients to other assistance programs if necessary.

The $98.9 million is above the $80 million that CMS gave to Navigators for the 2022 coverage year. The program’s funding was cut to $10 million during the Trump administration, but the Biden administration has sought to reverse those cuts. 

Brooks-LaSure said that Navigators were pivotal in helping ACA enrollment reach a record-breaking 14.5 million people for 2022. 

“Last year more than 1500 certified navigators held more than 1800 outreach and education events at accessible areas such as local libraries,” she said.

Another key driver of that enrollment bump was enhanced subsidies to help lower the cost of insurance, which Congress extended through the 2025 plan year. 

For the 2023 open enrollment, Navigators can use the funding to get additional staff and conduct more targeted outreach for high-need communities. 

“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,” according to a CMS release on the funding.

The funding awards are the second installment of a three-year period that includes performance agreements for the organizations. The goal of the multiyear period is to help ensure consistency for the local nonprofit organizations. 

ACA open enrollment will stretch from Nov. 1 through Jan. 15, 2023.

CMS’ efforts to expand coverage on the exchanges got a major boost from Congress earlier this month. The Inflation Reduction Act that President Joe Biden signed into law would extend enhanced tax credits. 

“With the Inflation Reduction Act now signed into law, an estimated 13 million people will continue to save an average of $800 per year on their Marketplace health insurance,” the CMS release said.