Uneven Funding Provides Opportunity for Agent and Brokers in Federal Exchanges

It seemed like everyone in Washington last week was discussing the upcoming outreach and enrollment prospects for the federal and state exchanges. Kaiser Family Foundation held a forum on Consumer Assistance that emphasized the uneven funding among states in the first year and the need for coordination among the various types of assistance programs. Several Congressional hearings and news articles also focused on the large discrepancy in funds for Navigators and In-person Assisters that will be available in state-based Exchanges and Consumer Partnership Exchanges compared to the Federal Exchange (FFE). HHS announced the availability of $54 million for Navigator grants for the 33 Federally operated and State Partnership exchanges. The Navigator grants range from $600,000 per state to over $8 million based on a formula that considers the size of a state and the number of uninsured. There will be no funds available for In-person assistance programs in the FFEs. In contrast, State-based Exchanges can use federal Exchange grant funding for their Navigator and In-person assistance programs. California expects to spend $43 million, New York will spend $27 million and Maryland will spend $25 million on outreach, and enrollment and application assistance for Navigators and In—person assisters. Ohio with 1.5 million uninsured will receive a $2.2 million Navigator grant and will not have a consumer assistance program.

The gap in Navigator and consumer assistance funding in Federal Exchanges offers an opportunity for agents and brokers to serve a more critical role in helping the uninsured understand their options and enroll in Exchange products.

Resources

To learn how Gorman Health Group can help your organization get involved in the Exchanges or other government programs, visit our website.

Gorman Health Group SVP of Public Policy, Jean LeMasurier, summarizes the proposed CMS regulation CMS-9955-P- Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel.

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