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Exchange Navigators

Exchange Navigators

by Matthew Valeta, Health Policy Fellow

Colorado is currently moving forward with the creation of a health benefit exchange. The exchange will be an online market place for Coloradans to compare and purchase health insurance plans starting in 2014. Many Coloradans will qualify for subsidies to help them purchase health insurance in the exchange.

The success of Colorado’s exchange will largely depend on how many Coloradans enroll. To facilitate enrollment in the exchange, Obamacare requires that state exchanges create a Navigator program to assist consumers through the process of selecting an insurance plan.

The Navigator program will be especially important to the success of the exchange as it is expected that 65% of individuals who will purchase insurance through the exchange will have been previously uninsured. The exchange’s Navigators will be a valuable resource for consumers to help them easily use the website and assist them in finding a health insurance plan. Therefore, Navigators will have several responsibilities.

  • Educating the public about the exchange.
  • Providing information concerning enrollment into qualified health plans, premium tax credits, and cost-sharing reductions.
  • Facilitating selection of and enrollment in qualified health plans.
  • Providing this information so that it is culturally and linguistically appropriate for the population the exchange is serving.

Here in Colorado, several individuals and organizations already provide support for enrollment in health plans similar to the Navigators program. These include insurance producers, state and local human service agencies, hospitals and community health clinics, and community-based organizations. Obamacare also suggests community and consumer-focused nonprofit groups, trade, industry, and professional associations, chambers of commerce, unions, and licensed insurance agents and brokers as possible Navigators. In fact, Obamacare requires that the exchange choose at least one community and consumer focused nonprofit to serve as Navigators.

There are limitations on who can serve as Navigators to avoid potential conflicts of interest. Navigators cannot be a health insurance issuer, receive any consideration from health insurance issuers for assisting with the enrollment in qualified health plans, or lobby for the insurance industry.

CCHI, and its partners CCLP and COPIRG, are reaching out to community based organizations and consumers to see what they need from a Navigator program. If you are interested in sharing your perspective with CCHI contact Adam Fox at afox@cohealthinitiative.org or at 303-839-1261.

Getting the care you need when you need isn’t too much to ask. The Navigators in Colorado’s exchange will be a valuable resource for Coloradans to find affordable health insurance. Make sure that your voice is heard about what you need from Navigators and Colorado’s exchange.

If you are interested in learning more check out our paper on Navigators here.
 

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