Future Of Navigator Grants Questioned

By Christine Kern, contributing writer

Some advocates worry 2015 Navigator Grant funding will dwindle

Consumer advocates are nervous that HHS' next round of grants for navigators in federal and partnership exchange states won't be enough to fund the success of the programs. The 2014 awards totaled $67 million, but supporters point out that in-person assistance played a critical role this enrollment season and will likely be increasingly important during the 2015 enrollment period, which is three months shorter.

According to InsideHealthPolicy, sources also say that it is unclear exactly when HHS will release the 2015 navigator grant funding announcement, although last year the announcement came out in April and applications were due in early June.

The 2014 navigator awards, spread among the 34 states with a federally-run or partnership exchange, were finalized by HHS last August, barely two months prior to the initial open enrollment period. Subsequently, the department quietly awarded almost $30 million in contracts to SRA International and Cognosante funding additional enrollment and outreach workers in 10 crucial FFE states.

HHS will in all likelihood not have increased funding for navigator grants, and probably will not continue to fund SRA and Cognosante contracts into the 2015 open enrollment period. Advocates argue that the loss of those contracts and potentially stagnant grant funding strains in-person outreach opportunities for 2015. The shorter open enrollment period slated for 2015 – going from Nov. 15 to Feb. 15, 2015 –makes additional funding more important.

"The next open enrollment period runs for just three months (and includes the Thanksgiving and Christmas holidays), compared to six months for the first open enrollment period, making enrollment assistance even more important," Families USA writes in a report outlining 10 recommendations on how to boost enrollment in the future. The report criticized the uneven distribution of navigator resources, with combined funding this year for 34 states in federally managed marketplaces equal to $67 million, while California alone had funding of $40 million.

One complication with navigator grants, particularly in the first year, was that they couldn't be funded with exchange establishment grants to the states, and exchange operational funding was not available going into the first open enrollment period.

For 2014, all $67 million in grants came from the ACA Prevention and Public Health Fund allocation for fiscal 2013. This move infuriated Senate health committee Chair Tom Harkin (D-IA), who had championed the fund and asked that it be strictly used for prevention-related activities. 2014 prevention funding was allocated as part of the omnibus spending bill passed in January, so HHS does not have access to it. But prevention fund money has not yet been allocated for specific areas for fiscal year 2015, which begins Oct. 1 – 45 days prior to the next enrollment period.

HHS' fiscal year 2015 budget request says the department plans to spend $1.8 billion to oversee FFE operations. Under that budget, HHS would spend $774 million on consumer outreach, though it's unclear how much of that is meant for navigator grants. Of the $1.8 billion, HHS says it expects $1.2 billion to come from exchange user fees but it has requested $629 million from Congress to fund the remainder.