It seems that word is getting out about one of the aspects of the Affordable Care Act that hasn’t been highlighted much before now. That is, the role of “navigators” and “in-person assisters” as they are called by the government. Many of the folks who read this blog are interested in whether there is a role for them (especially whether they can make any money from such a role!)
The answer is – maybe – but probably not. Because these “navigators” may not be what you think (or hope!) they are.
Reason #1: Obamacare navigators will be tasked with helping insurance customers – both individuals and small businesses – choose the right insurance plan for them to help them fulfill the individual mandate. This form of navigation will have nothing whatsoever to do with shepherding someone through their healthcare journey. It will have everything to do with helping them review and choose health insurance. If you are a patient advocate who works in the insurance realm, you may find something here, but….
Reason #2: ACA Insurance Navigators will be organizations, not individuals. They will be groups like Chambers of Commerce or senior groups or church groups or small business organizations. Now, it is possible that a for-profit business might be selected to be an ACA Navigator, but since none of this choosing has happened yet, we just don’t know. If a for-profit entity is chosen to be a navigator, there will be a list of proficiencies it will have to showcase ranging from cultural and literacy knowledge to knowledge of health insurance plans in general.
Reason #3: Navigators will function only in those states that establish Insurance Exchanges (also called Marketplaces). As of early April 2013, only 18 states have decided to host their own exchanges. It is thought that “in-person assisters” will be used in the states that do not develop exchanges but again, since none of this has been implemented yet, there are still questions.
There is much still to be decided, and an entire system to be implemented before ACA navigators begin serving consumers to help them choose the right insurance program for them. The target date for the opening of the exchanges / marketplaces is October 1, 2013.
APHA Members: If you have questions about these new navigators, please post them in our Forum so we can share answers with others (You’ll find the question has been added to our Forum.)
If you are not an APHA member, you can sign up to be notified with updates here.
Update April 9, 2013: new information was forwarded from CMS this afternoon and has been posted in the APHA forum for those who are interested.