HHS Announces the Largest Ever Funding Allocation for Navigators and Releases Final Numbers for 2021 Marketplace Open Enrollment
Today, the U.S. Department of Health and Human Services (HHS) announced that to continue its efforts to increase access to enrollment assistance for consumers, the Centers for Medicare & Medicaid Services (CMS) will make $80 million available in grants to Navigators in Federal Marketplaces for the 2022 plan year. The funding, which will be used for outreach and education efforts, is the largest allocation CMS has made available for Navigator grants to date and represents an eight fold increase in funding from the previous year. CMS invested $10 million annually in the Navigator program beginning with funding awarded in 2018 for the 2019 plan year. CMS awarded $36.2 million in 2017 for the 2018 plan year, down from a high of $63 million awarded in 2016 for the 2017 plan year.
The Department also released the 2021 Marketplace Open Enrollment report, which shows over 12 million consumers nationally selected a Marketplace plan during the 2021 Open Enrollment Period (OEP), a 5% increase from the 2020 OEP.
The Biden Administration opened a Special Enrollment Period (SEP) in response to the COVID-19 Public Health Emergency from February 15 to August 15, 2021. The SEP, along with the additional financial assistance afforded by the American Rescue Plan, offers the opportunity for individuals and families to take advantage of significantly reduced premiums, increased savings, and quality, affordable health coverage through the Marketplaces using the Federal Platform right now. More than 500,000 Americans have signed up for Marketplace coverage through HealthCare.gov during the SEP.
“Navigators play a key role in helping us educate consumers about health plan options. Today’s announcement builds upon the steps the Administration has taken to ensure individuals and families can access quality, affordable health coverage during the COVID-19 pandemic,” said Secretary Becerra. “This eight-fold increase in Navigator funding will help consumers deciding whether to enroll or continue their health care coverage through HealthCare.gov during the Open Enrollment period this fall.”
Navigators are a network of trained individuals that help consumers review their health coverage options as well as complete eligibility and enrollment forms. They serve an important role in connecting communities that historically have experienced lower access to health coverage and greater disparities in health outcomes to health coverage. Their mission focuses on assisting the uninsured and other vulnerable communities. The funds will provide vital support and resources to these communities once awarded.
In addition to the increase in number of overall plan selections, the 2021 Marketplace Open Enrollment report also reveals an increase in the number of returning customers continuing their coverage relative to new consumers enrolling in a Marketplace plan. This is primarily due to higher enrollment through special enrollment periods in 2020 and a larger percentage of enrollees with 2020 coverage remaining in their plans for the full year. Nationally, returning consumers made up 79% of consumers with a plan selection during the 2021 OEP, compared to 75% in the 2020 OEP.
In states with Marketplaces using the HealthCare.gov platform, 88% of enrolling consumers lowered their premiums with advance payments of the premium tax credit (APTC) in the 2021 OEP, a one-percentage point increase from the 2020 OEP. Among consumers receiving APTC, the average APTC amount covered 85% of the total premium in both the 2020 and 2021 OEP, based on the plan a consumer selected.
Additional data on demographics, including income, premiums and financial assistance for the states with Marketplaces that use the HealthCare.gov platform are also included in the 2021 Marketplace Open Enrollment Report.
Details about the Navigator grant funding, including eligibility requirements and required Navigator duties, are available through the 2021 Navigator Notice of Funding Opportunity (NOFO) Forecast. The 2021 Navigator NOFO will be released later this spring as indicated in the NOFO Forecast. All information contained in the forecast is subject to change, including the availability of funding. No applications are being accepted at this time.
Consumers who want to enroll in coverage and see if they qualify for more affordable premiums can visit HealthCare.gov or CuidadoDeSalud.gov to view 2021 plans and prices and, if eligible, enroll in a plan that best meets their needs. Additionally, consumers can call the Marketplace Call Center at 1-800-318-2596, which provides assistance in over 150 languages. TTY users should call 1-855-889-4325. Consumers can also find a local assister or agent/broker in their area: https://localhelp.healthcare.gov. Eligible consumers can apply through HealthCare.gov through August 15, 2021, to gain access to the Special Enrollment Period to change or update their plan choices.
Consumers who live in a state that operates its own Marketplace platform should visit their state Marketplace website or call center for more information about enrolling in coverage.
To view the 2021 Marketplace Open Enrollment Report, visit:https://www.cms.gov/files/document/health-insurance-exchanges-2021-open-enrollment-report-final.pdf
To view the Navigator Notice of Funding Opportunity Forecast, visit: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/assistance.
For more information on the 2021 Marketplace Open Enrollment Public Use Files, visit: https://www.cms.gov/research-statistics-data-systems/marketplace-products/2021-marketplace-open-enrollment-period-public-use-files.
For more information about the Health Insurance Marketplace®, visit: https://www.healthcare.gov/quick-guide/getting-marketplace-health-insurance/.
 Health Insurance Marketplace® is a registered service mark of the U.S. Department of Health & Human Services.