The Biden-Harris Administration Hugely Funds Navigators for the Open Enrollment Period

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is investing $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period to help consumers navigate enrollment through the Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP) and make health coverage more equitable and accessible to everyone. 

Historic investment of nearly $100 million builds on the Administration’s quadrupling of Navigators last year to help connect people to coverage

The announcement made August 26th marks the single largest Navigator funding award provided to date and serves as a continuation of historic levels of funding. The Biden-Harris Administration previously awarded $80 million to the program, quadrupling the number of Navigators for the 2022 Open Enrollment Period. More than 1,500 certified Navigators held more than 1,800 outreach and education events at accessible areas—such as local libraries, vaccination clinics, food drives, county fairs, and job fairs. This historic investment in outreach and enrollment efforts helped contribute to the record-breaking 14.5 million people who signed up for 2022 health care coverage through the Marketplaces, including nearly 6 million people who newly gained coverage.

“This is a historic investment to connect people to high-quality, affordable health care,” said HHS Secretary Xavier Becerra. “Last year, our investments helped result in the lowest uninsured rate in our nation’s history. This year, we’re doubling down on our efforts to ensure people get the insurance they need. Navigators critically help us reach people where they are, educating them on their health insurance options that can be lifesaving.”

“Reaching people where they are is a key part of our strategy to connect people to health coverage. Navigators were incredibly effective during the last Open Enrollment period when a historic number of people signed up and now we are doubling down on investing in community Navigators who can help people find the coverage they need,” said CMS Administrator Chiquita Brooks-LaSure. “For those changing coverage or who struggle to afford health insurance, there are a variety of options to help.  The Health Insurance Marketplace® and state-based Marketplaces can offer no-cost or low-cost coverage to millions of people.”

Illinois has been pushing for extended coverage, especially since the pandemic 

These awards will enable Navigator organizations to retain staff and add to the more than 1,500 existing Navigators who were trained to help consumers find affordable, comprehensive health coverage in nearly every HealthCare.gov state and county during the 2022 open enrollment period. This follows a historic Open Enrollment Period in 2022 and is part of the Biden-Harris Administration’s efforts to enroll more people in health care coverage.

The Illinois administration also took steps to ensure extended coverage, especially since the pandemic revealed some undenying truths about our healthcare system. 

In April 2020, Illinois Gov. J.B. Pritzker has announced “Care Comes First,” an action plan to ensure an expansion of medical coverage across the state.

The action plan, a series of activities that expands and expedites Medicaid coverage for the duration of the coronavirus outbreak, was led by the Illinois Department of Healthcare and Family Services. Medicaid is a government-funded health insurance program for the poor and disabled.

One of the most affected sections of the population has been the undocumented older immigrants. Hurdles to healthcare for the undocumented have always gone beyond policy and vary from financial difficulties to discrimination, as well as fear of deportation. Policies that prevent undocumented immigrants from seeking medical care are prevalent and vary from state to state. Some range from denying undocumented immigrants total access to care to providing limited access to emergency or preventative medical assistance.

But there was some light into what has been a long and dark tunnel of fear and hurt. Amid surging cases of the pandemic that have severely impacted low-income communities, Illinois paved the way by becoming the 1st state to provide low-income undocumented seniors with public health insurance.

Navigators operate year-round, increasing awareness among the remaining uninsured about the coverage options available

Navigators play a vital role in helping consumers prepare applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplaces, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators operate year-round, increasing awareness among the remaining uninsured about the coverage options available to them, helping consumers find affordable coverage that meets their needs, and assisting consumers beyond the enrollment process to ensure they’re equipped with the tools and resources needed to utilize and maintain their health coverage all year. Navigators must complete comprehensive federal Navigator training, criminal background checks, and state training and registration (when applicable), prior to assisting consumers.

The 2022 Navigator awardees will continue to focus on outreach to particularly underserved communities and includes $12.5 million to support additional direct outreach, education, and enrollment activities aimed at helping eligible individuals transition from Medicaid/CHIP to Marketplace coverage. Additional funds may be used for hiring additional Navigator staff to expand in-person services to more locations across their state, targeting outreach efforts in areas of high-need, and increasing enrollment assistance capacity through the use of virtual and telephonic appointments.

Minorities, refugee and immigrant communities, low-income families and veterans, among the categories to focus on

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.

The 2022 Navigator awards are the second installment of a three-year period of performance agreement funded in 12-month increments known as budget periods. This multi-year funding structure is designed to provide greater consistency for Navigator awardee organizations, reducing yearly start-up time and allowing more efficient use of grant funds.

The Biden-Harris Administration has worked tirelessly to expand access to health insurance and lower costs for America’s families, and thanks in part to these historic investments and unprecedented outreach efforts, the national uninsured rate has reached an all-time low of 8 percent under the Biden-Harris Administration – PDF. 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, continuing the savings consumers received during 2021 and 2022 from President Biden’s American Rescue Plan.

Marketplace Open Enrollment for 2023 starts November 1, 2022 and ends January 15, 2023.

For more information, visit HealthCare.gov.

To view the list of 2022 CMS Navigator Awardees, you can visit the navigator grantee list.