Survey of Health Insurance Marketplace Assister Programs
Marketplaces can take a number of steps to improve the overall efficiency of Assister Programs. Officials can be encouraged that so many Assister Programs and staff intend to stay on the job. Experience can only enhance Assister efficiency. Marketplaces can seek other ways to foster the professional development of Assisters so that they continue this work over the long term. In addition, Marketplaces can take steps improve their web sites and call centers to reduce delays for both consumers and Assisters. Building Assister portals into online Marketplace application systems could reduce Assister time on hold with call centers and enhance ability to follow up with clients and ensure completed enrollments. Marketplaces can also expand training and technical assistance resources to enhance efficiency of Assister Programs.
Financial support of Assister Programs will also surely matter. The ACA requires that all Marketplaces establish Navigator Programs and pay for them out of Marketplace operating revenues – in effect, building the cost of consumer assistance into the overall cost of coverage. Because Marketplaces did not have operating revenues in time for the first Open Enrollment, this is not how most Programs were financed in the first year. Instead, about $100 million in funding came from Exchange establishment grants, another $208 million came from HRSA grants to FQHCs, and $105 million came from CMS ACA implementation funds.
In fiscal year 2015, CMS expects to collect about $1.2 billion in operating revenue through an assessment on insurers that participate in FFM states.2 For the 2014-2015 cycle, CMS has announced that $60 million will be available for grants to Navigators in FFM states, 90% of the first year total. CMS has not specified the source of this funding or indicated whether an ongoing portion of Marketplace operating revenue may be set aside for consumer assistance or in what amounts.3 In addition, no decision has yet been announced on whether to continue funding for FEAPs for a second year. Most states have yet to announce what the amount or source of their Marketplace Assister Program funding will be for next year. For 2015, HRSA anticipates that health center funding for outreach and enrollment will continue at about the level awarded in July 2013 ($150 million). The level of financial resources for Marketplace Assister Programs (and for CAPs tasked with addressing post-enrollment problems) available in the future remains to be seen.