HHS to spend $80 million to fund Navigators for marketplace enrollment

April 22, 2021

The U.S. Department of Health and Human Services (HHS) announced that to continue its efforts to increase access to enrollment assistance for consumers, the Centers for Medicare & Medicaid Services (CMS) will make $80 million available in grants to Navigators in Federal Marketplaces for the 2022 plan year.

The funding, which will be used for outreach and education efforts, is the largest allocation CMS has made available for Navigator grants to date and represents an eight-fold increase in funding from the previous year. CMS invested $10 million annually in the Navigator program beginning with funding awarded in 2018 for the 2019 plan year. CMS awarded $36.2 million in 2017 for the 2018 plan year, down from a high of $63 million awarded in 2016 for the 2017 plan year.

The department also released the 2021 Marketplace Open Enrollment report, which shows over 12 million consumers nationally selected a Marketplace plan during the 2021 Open Enrollment Period (OEP), a 5% increase from the 2020 OEP. The Biden Administration opened a Special Enrollment Period (SEP) in response to the COVID-19 Public Health Emergency from Feb. 15 to Aug. 15, 2021. The SEP, along with the additional financial assistance afforded by the American Rescue Plan, offers the opportunity for individuals and families to take advantage of significantly reduced premiums, increased savings, and quality, affordable health coverage through the Marketplaces using the Federal Platform right now. More than 500,000 Americans have signed up for Marketplace coverage through HealthCare.gov during the SEP.

Secretary Xavier Becerra said, “This eight-fold increase in Navigator funding will help consumers deciding whether to enroll or continue their health care coverage through HealthCare.gov during the Open Enrollment period this fall.”

Navigators are a network of trained individuals that help consumers review their health coverage options as well as complete eligibility and enrollment forms. They serve an important role in connecting communities that historically have experienced lower access to health coverage and greater disparities in health outcomes to health coverage. Their mission focuses on assisting the uninsured and other vulnerable communities. The funds will provide vital support and resources to these communities once awarded.

In addition to the increase in number of overall plan selections, the 2021 Marketplace Open Enrollment report also reveals an increase in the number of returning customers continuing their coverage relative to new consumers enrolling in a Marketplace plan. This is primarily due to higher enrollment through special enrollment periods in 2020 and a larger percentage of enrollees with 2020 coverage remaining in their plans for the full year. Nationally, returning consumers made up 79% of consumers with a plan selection during the 2021 OEP, compared to 75% in the 2020 OEP.

In states with Marketplaces using the HealthCare.gov platform, 88% of enrolling consumers lowered their premiums with advance payments of the premium tax credit (APTC) in the 2021 OEP, a one-percentage point increase from the 2020 OEP. Among consumers receiving APTC, the average APTC amount covered 85% of the total premium in both the 2020 and 2021 OEP, based on the plan a consumer selected.

Additional data on demographics, including income, premiums and financial assistance for the states with Marketplaces that use the HealthCare.gov platform are also included in the 2021 Marketplace Open Enrollment Report.

CMS has the release.