CMS has just released a proposed rule on the role and place of ACA navigators or consumer aides who will help uninsured Americans apply for insurance through the Exchanges. As Missouri will not operate its own Exchange, I am particularly interested in who is going to help consumers navigate the federally facilitated Exchange here. And I would like to understand the difference between navigators and "non-navigator assistance personnel."
I suppose some of this is self-interested. I like to think I put myself out there to be helpful but I can tell you I am utterly overwhelmed with questions about the ACA, usually along the lines of "What will the ACA mean for me?" No surprise that the answer requires a certain amount of knowledge of the ACA and a certain amount of training and experience in insurance counseling.
I sometimes joke that the first assignment of a health law professor is to explain the university's health insurance program to the faculty and staff and then to be a teacher and scholar. If my faculty and staff peers cannot get a handle on this stuff, how will the average American, particularly in a state uninterested in explaining the law to the broader population?
So far, all of the focus has been on who a navigator or non-navigator assistance personnel may not be. By this, I mean the big quarrels have been over excluding insurance brokers from eligibility and CMS's requiring that state requirements for licensing or certifying navigators may not conflict with the ACA. Yes, the revenge of the disintermediated is a fearsome thing.
I can't help but wish, though, that more thought were being given to what would make a good navigator or non-navigator assistance personnel. Many moderate income Americans will need assistance from these people. I would like to know who they are. Enrollment begins in October, you know. Or, did you not know that?
1 thought on “Who’s My Navigator?”
As a consulting health actuary I have been giving serious thought to signing up as a Navigator. My shortfall will be in the culturally and linguistically appropriate requirement. It makes sense to me to use existing Medicaid infrastructure to handle the necessary people skills while I could provide guidance on cost/benefit issues (such as cost sharing, subsidy determination etc.)