Navigator Grants, New Hardship Guidance From CMS

Just what we need; less ability to find usable health insurance…

On September 12, 2018, the Department of Health and Human Services (HHS) announced its next round of grants for the navigator program in the states with a federal marketplace. The number of navigator organizations has been cut by about half, likely because of significantly reduced funding for 2019.

HHS also released new guidance on hardship exemptions from the individual mandate for 2018. The guidance appears to allow all hardship exemptions to be claimed directly from the Internal Revenue Service (IRS), meaning consumers will not need to obtain a certificate from the marketplace first.

HHS Finalizes Significant Cuts To Navigator Funding

HHS selected 39 organizations to serve as navigator grantees for the 2019 plan year in the 34 states with a federal marketplace. The number of navigator grantees is reduced significantly from 2018, when more than 80 organizations served as navigators. For 2019, there are three states—Iowa, Montana, and New Hampshire—where no organization applied to be a navigator. This is the first time this has happened since navigator grants were awarded in 2013 and likely stems from the changes that HHS has made to the navigator program over the past year.

In addition, there are entire areas within some states that will not be served by the navigator program, including Cleveland and Akron in Ohio as well as Dallas and San Antonio in Texas. Many long-standing, experienced navigator organizations did not receive funding, either because they did not apply or were not selected. Those that did saw their funding reduced significantly; for example, the University of South Florida saw its funding reduced from about $4.9 million for 2018 to $1.25 million, even as other long-standing navigator partners were not funded in Florida.

Overall, navigator funding was cut dramatically to $10 million for 2019. This is down from $36.8 million for the 2018 plan year (which was, itself, cut from about $63 million for 2017).

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