Policy Examples

  • The Affordable Care Act (ACA) created the navigator program. Navigators are individuals or organizations trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased. Their services are free to consumers. source

Outcome Evidence

  • Brokers help consumers apply for financial assistance and enroll in a Qualified Health Plan (QHP). There were 48,069 brokers registered in 2019. source
  • At the onset of the ACA, few states engaged brokers. In California, 39% of people who enrolled through the state's exchange used a broker; while in Kentucky, 44% did. The efficiency of the broker program is dependent on the level of engagement from states. source
  • For the 2016-2017 year, there were 104 navigator programs serving the 34 federal marketplace states, compared to 40 for the 2018-2019 year, seven of which were new grantees. source
  • In 2017, 83% of navigators met or exceeded performance metrics for one-on-one consumer interactions, 71% met or exceeded metrics for helping consumers eligible for Medicaid/CHIP, and 75% met or exceeded performance metrics for outreach and public education. source
  • The ACA’s navigator program has been critical in regions of the country where brokers may not be available, for lower-income and/or non-English-speaking consumers, and for people who either may not know where to look for a broker or may not be familiar with a broker’s role in insurance markets. source
  • The Kaiser Family Foundation found that navigators were more likely than insurance brokers to have clients who were uninsured, low-income, Latino, or who had no internet access, based on a 2018 study. source
  • In 2019, Blue Cross & Blue Shield of Illinois reported the launch of Be Covered, a campaign aimed at removing barriers to health insurance enrollment in advance of the open enrollment period. The campaign will help uninsured and underinsured populations understand the benefits of enrollment and identify subsidy eligibility options through the website BeCovered.org. source
  • In 2019, the Idaho Department of Health & Welfare conducted an assisted enrollment program to help almost 70,000 Idahoans sign-up for coverage under Medicaid expansion. The state began notifying eligible residents in July, of which 17,000 have confirmed they plan to enroll. source

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