Navigators and In-Person Assistors: State Policy and Program Design Considerations
State Health Reform Assistance Network - Shelly Ten Napel and Daniel Eckel
This brief, prepared by State Network staff, outlines important policy issues for states to consider while implementing their Navigator and In-Person Assistor (IPA) programs as well as summarizes the basic information and guidance released to date. The brief concludes with a compilation of resources, program structures, and ideas from leading State Network states. The Affordable Care Act (ACA) and related guidance have established Navigators and IPAs to help individuals enroll in Health Benefit Exchanges (Exchanges). Regardless of the type of Exchange, every state will have Navigator and In-Person Assistor programs and several states have begun to make policy and operational decisions that could be informative to other states.
This brief, part of a developing series of reports related to consumer assistance, reflects an effort to curate the growing number and depth of resources available to state policymakers on this topic. Wakely Consulting Group has produced a brief, What Should Exchanges Know about Call Centers: A Guide for Implementation, which offers states strategies and best practices for call center management. For a high level overview of consumer assistance see the brief prepared by the National Academy for State Health Policy.
In February, Galen Benshoof underscored the importance of agents and brokers in ensuring robust enrollment and exchange sustainability. Recognizing this, the State Network funded programs in Illinois and Minnesota, led by Wakely Consulting Group (Wakely), to enhance in-person agent and broker engagement while expanding their capability to assist anyone who walks through their doors, even if they are eligible for Medicaid or other state coverage programs. These Lead Broker Agency programs were a success, and the states are planning to continue or expand the programs next year!
A new issue brief, prepared by Kathie Mazza at Wakely, describes the concept of these pilots and outlines how other states interested in partnering with insurance brokers can implement similar initiatives for future open enrollment periods.
Student health plans have long been a source of coverage for college students who do not have other options available. In 2012, the U.S. Department of Health and Human Services redefined student health plans under the Affordable Care Act (ACA), requiring that they be treated like individual health insurance. This means that students buying these plans through their college or university now have the same protections available to them as if they bought a plan in the individual market. It also means that states and the federal government have a new role in oversight of these plans.
The State Network team mourns the recent passing of our dear friend and colleague, Andy Hyman. Andy was the father of the State Network, seeing the value in connecting states with the expertise they need to achieve the vision of coverage that drove him every day.