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HIX Navigator Grants Get $67M Boost

 |  By Margaret@example.com  
   August 20, 2013

States that have declined to set up their own health insurance exchanges will receive additional funds to help individuals work through online health plan options.

In a surprise move Obama administration officials announced last week the addition of $13 million to the grant amount awarded to community groups that will help individuals "navigate" their way through the on-line health insurance marketplaces expected to begin operation on Oct. 1.

The 105 organizations selected will now share $67 million in grants rather than $54 million as was first announced in April. The increased funding, which officials stressed is not new money, was allocated to the Department of Health and Human Services from a prevention fund created by the Patient Protection and Affordable Care Act.

The grant recipients are from states, including Florida, Texas, and Tennessee, that declined to set up their own health insurance exchanges and instead will rely on the federal government to operate their exchanges.

While the reason behind the increase was not directly addressed, concern has been expressed from several quarters that navigator funding for the federal HIX pales when compared to the funding for state-based exchanges.

Certified application counselors, more commonly known as navigators, will provide hands on, in-person help to educate consumers—many from among the ranks of the uninsured—about the online health plan options offered through the marketplaces, the eligibility requirements, and the application process.

The grantees include community groups, a Catholic health system, universities, patient advocacy groups, food banks, and United Way and Planned Parenthood affiliates. The grant amounts range from $20,750 awarded to the Catholic Social Services-Archdiocese of Mobile (Alabama) to $5.9 million awarded to the United Way of Metropolitan Tarrant County (Texas).

In addition to funding concerns, the navigator program has come under fire from elected officials concerned about the training of navigators and their access to private consumer information, including Social Security numbers.

Last week attorneys general from 13 states sent an 8-page letter to HHS Secretary Kathleen Sebelius outlining their concerns about a lack of uniform background or fingerprint checks.

In her prepared comments, Sebelius stated that the navigators will be required to "adhere to strict security and privacy standards," including how to safeguard a consumer's personal information. Navigators will subject to federal criminal penalties for violations of privacy or fraud statutes, as well as relevant state law penalties.

To be certified a navigator must attend 20–30 hours of on-line as well as additional training throughout the year. The certification process calls for an annual training, and yearly re-certification.

Training is expected to begin later this month and navigators may begin outreach activities as soon as their training is complete, according to Chiquita Brooks-LaSure, deputy director of policy and regulation at the Center for Consumer Information and Insurance Oversight at HHS. Actual enrollment, however, will not take place until Oct. 1.

A recent survey from HealthPocket suggests that navigators will face an uphill battle in reaching out to younger consumers. Only 3% of respondents in the 18 to 34-year age group expect to get advice from a navigator. That group of younger, healthier individuals is needed in the HIX to bring balance to the enrollee mix and to improve the financial viability of HIX.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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