House Lawmakers Grill CMS Over Health Exchange Navigators

Margaret Dick Tocknell, for HealthLeaders Media , May 22, 2013

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.

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2 comments on "House Lawmakers Grill CMS Over Health Exchange Navigators"

ibjim (5/24/2013 at 6:56 PM)
The process for signing up for healthcare insurance under Obamacare will be greatly simplified. The exchanges are set up to compare apples to apples, etc, much different than today's complex health insurance offerings. You should look at some of the sample marketplace exchanges that are in demonstration mode already around the country - the Kaiser Foundation, Cover Oregon, Washington Health Exchange, etc. Put in your information, decide your level of coverage, choose your plan, sign up, pay the first premium, presto, you're done.

Rod Humphrey (5/22/2013 at 2:07 PM)
I feel as though the only ones that should be able to be properly skilled enough would be currently Licensed Health Agents, as they not only have 24 Hours of Continuing education requirements Yearly, but have local basic market knowledge to know which products would be best for each and every individual, whereas churches and non profits have very little expertise in this arena, and even 20 hours of training, isn't going to be any even be enough to scratch the surface of the knowledge level required especially since many states have opted out of their own State sponsored Exchanges as Pennsylvania has for example, and no guidance is yet available as of this date for the Federal exchanges availability as of yet either! Let the Pros handle it, they're already licensed!!!! Felons are not allowed to be licensed in any state to my knowledge, so that would take care of that, and there is oversight of licensed agents already in place via the appropriate states!




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