A new policy brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) looks at the role played by navigators and in-person assisters as the third open enrollment period for the insurance Marketplaces begins.
A 2014 Kaiser Family Foundation survey found that during the first open enrollment period, navigators, in-person assisters (also known as IPAs), and other assisters helped more than 10.6 million people apply for health insurance and obtain financial assistance. A provision of the Affordable Care Act (ACA) made funding for IPAs (but not for navigators) available to states that set up their own exchanges but less so for those states relying on the federal Marketplace.
This brief outlines the current responsibilities of navigators and assisters, and how these roles have evolved and may change.
What's the Law?
As the brief explains, the ACA lists the duties of navigators and the training requirements instituted by the Department of Health and Human Services (HHS). The brief notes the differences between states relying on the federal Marketplace and state-based exchanges, adding that the role of IPAs was not part of the ACA legislation but established by HHS under its regulatory authority.
What's the Debate?
Since many navigators and IPAs were funded through one-year grants, their continuity has sometimes been precarious. As the brief explains, some states turned to insurance agents and brokers, many of whom did not embrace the ACA, to fill the void. The brief provides examples of ways different states used brokers to fill consumer assistance needs — and also points out that although brokers may continue to play an integral role in enrollment going forward, they may have less experience with assisting some hard-to-reach populations that the Marketplaces are trying to enroll.
What's Next?
As the third open enrollment period gets underway, the brief observes that leveraging relationships with brokers can help fill gaps in consumer assistance and leave time for navigators to focus on tough cases and hard-to-reach populations. HHS recently announced $67 million in grant funding for navigators, with the possibility of three-year grants, bringing peace of mind to navigator entities that worry about the sustainability of their work.
About Health Policy Briefs
Health Policy Briefs are aimed at policy makers, congressional staffers, and others needing short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.
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from Health Affairs Blog http://ift.tt/1FwCbYM
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