The Centers for Medicare and Medicaid Services will base the next round of grants for health insurance Navigator organizations on how well the organizations have been making their numbers, officials say.
A Navigator organization is an entity that helps consumers understand health insurance options and use the Affordable Care Act public health insurance system. The people who deliver Navigator services are not supposed to recommend specific plans or issuers.
CMS will link an organization’s grant amount for the 2018 open enrollment period to the organization’s success at meeting its 2017enrollment goals, according to a new memo from Randy Pate.
An organization that achieved just 30% of its 2017 enrollment goal will get 30% of the funding it received for 2017, Pate writes.
An organization that met its 2017 enrollment goal will get 100% of its 2017 funding, Pate writes.
Pate did not give an example of how CMS would calculate the 2018 grant amount for an organization that exceeded its 2017 enrollment goal.
Pate is the director of the Center for Consumer Information & Insurance Oversight, the CMS division that runs the Affordable Care Act programs that affect the commercial health insurance market.
The ACA exchange system helped about 12 million people enroll in private health plan coverage for 2017.
The open enrollment period for 2018 is set to start Nov. 1 and run until Dec. 15 in most of the country.