CMS Focuses Health Plan Navigator Program on Underserved Groups

The Centers for Medicare & Medicaid Services (CMS) has awarded a new round of $100 million in funding to organizations that help consumers and small businesses find and enroll in health coverage through HealthCare.gov.

Navigator programs offer free assistance to people exploring health coverage options through HealthCare.gov, from reviewing available plans to assisting with eligibility and enrollment forms, and post-enrollment services such as using their coverage to get care. Navigators can also assist people in helping enroll in or renew Medicaid and Children’s Health Insurance Program (CHIP) coverage.

During the plan year 2024 Marketplace Open Enrollment Period, 21.4 million people selected plans through HealthCare.gov and state-based marketplaces, including with the help of Navigators. |

To continue the momentum and encourage smaller community-based organizations to become Navigators, CMS said it streamlined and simplified the application process this year. CMS also continues to advance requirements that Navigators focus their outreach on underserved groups that have accounted for more than 20% of Marketplace enrollees in recent years.

For example:
• Rural Health Project Inc. is a new Navigator grantee that will target 12 rural counties in northwestern Oklahoma — home to one of the largest U.S. populations of citizens from the Marshall Islands. By providing language support in Marshallese, Rural Health Project is one of several Navigator groups working to improve the quality and cultural competency of Navigator services.
• New Navigator grantee Choose Healthy Life will employ a faith-based approach to target 15 counties across South Carolina, many representing Black and African American communities that remain uninsured. Faith-based groups benefit from high levels of trust among community members, and often provide wrap-around services that can address barriers to enrollment, such as childcare, emergency food assistance, and access to other social services.
• Foundation Communities, a returning Navigator organization, uses Census data to identify communities in and around Austin, Texas, that can benefit from assistance enrolling in healthcare coverage. These often include people with low incomes, as well as racial and ethnic minorities across more than 10 counties. Foundation Communities leverages its research to conduct focused outreach and education, particularly at community health fairs, food pantries, and resident events in affordable housing properties. 

“Everyone in this Administration believes healthcare is a fundamental right for all, not a privilege for the few,” said CMS Administrator Chiquita Brooks-LaSure, in a statement. “We continue to put weight behind that promise by ensuring the millions who still need coverage know affordable options are available. Having access to trusted local partners is key to improving access to health services, particularly for those who just need a little extra help to understand the critical lifeline available through the ACA Marketplace and how to choose the best plan to meet their needs.”