He noted that navigators and assistors will operate much like insurance brokers and agents and agents already do today—educating consumers about the marketplaces and insurance affordability programs, comparing plans, helping consumers receive eligibility determinations, and enrolling in coverage.
Felons as navigators?
Rep. James Lankford (R-OK), chair of the Subcommittee on Energy Policy, Healthcare, and Entitlements, asked about basic requirements to become a navigator. "Has HHS mandated criteria for individuals who would be navigators? Could felons, individuals convicted of identity theft, or high school dropouts become navigators and handle sensitive and personal information? Is there an expectation that a navigator will have any prior knowledge of the health insurance market? Is there an oversight plan?"
In his statement, Cohen noted that HHS has extensive experience providing outreach and enrollment assistance in Medicaid, the Children's Health Insurance Program (CHIP), and Medicare. "CMS designed navigator and in-person assistance grant programs that will allow qualified and well-trained individuals and organizations help consumers find and enroll in healthcare coverage, while adhering to standards and requirements designed to ensure that taxpayer money is used appropriately."
HHS has earmarked about $54 million to fund navigator in federal or state marketplaces. Cohen said the opportunity is open to the self-employed as well as community and consumer-focused non-profits. Trade, industry, and professional associations, commercial fishing industry organizations, ranching and farming organizations, chambers of commerce, unions, and licensed insurance agents and brokers may also apply.
The CMS Office of Acquisitions and Grants Management will oversee the review and evaluation of the grant applications. Grantees must also complete a 20-30 hour training program and pass an exam.