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Disparity Evident in Navigator Grants

Jacqueline Fellows, for HealthLeaders Media, April 10, 2013

Community health advocates in states that opted for the federally run health insurance exchange model breathed a tiny sigh of relief on Tuesday on news that the Centers for Medicare & Medicaid Services will award $54 million in grants to help states pay for the federally required navigator programs.

But the amount of money CMS is doling out isn't nearly enough to adequately help the number of uninsured Americans who are expected to enroll in the exchanges this October, hence the word tiny.

The Patient Protection and Affordable Care Act requires all insurance exchanges to have navigator programs, which must be comprised of at least two different entities, with one being a nonprofit, community-focused group. The intent of navigators is to help consumers understand the process, the plans, and the choices they have in regard to the exchange.

The rules change slightly according to which type of exchange a state has decided to develop. For example, all exchanges are required to have a navigator program. But, state-based exchanges and federal-partnership exchanges with a consumer assistance component, such as Arkansas, can also opt to have in-person assister programs. The only real difference between the navigators and IPAs is how they are paid.

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