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house Bill H.R. 7102

Should the Obamacare Patient Navigator Programs Be Funded?

Argument in favor

Navigators play an important role in helping individuals navigate the Obamacare marketplace to find the best health insurance plans for themselves. They reach out to under-served communities, help people with language barriers, and provide information about subsidies — all of which improves enrollment rates.

TrulyTexan's Opinion
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11/09/2018
If need be take the money from the grossly bloated military budget. Or trumps golf trips.
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Brian's Opinion
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11/09/2018
I strongly support healthcare and the affordable care act
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Mary's Opinion
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11/09/2018
Yes. Every piece of the law should be funded in full. Lack of certainty has created over conservative margin assumptions and unacceptable rate increases.
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Argument opposed

Navigators sign up only a small fraction — under one percent — of individuals, and it’s expensive to fund navigator programs. The role that they fulfill can also be performed by agents and brokers reimbursed by health insurance plans, which is a better option that saves federal funds for other uses.

Miles's Opinion
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11/09/2018
Nothing to do with Obamacare needs to be funded. It’s going to fall apart soon anyway. Joke of a policy that puts the needs of the few above the needs of the many. Idiotic to say the least
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Chester 's Opinion
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11/09/2018
Repeal Obamacare because it was and still is unconstitutional and Socialist!
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SneakyPete's Opinion
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11/09/2018
👎🏻👎🏻 H. R. 7202—AKA the ENROLL Act 👎🏻👎🏻 I’m strongly opposed and do not recommend the passage of H. R.7202—AKA the ENROLL Act — would amend the Patient Protection and Affordable Care Act (aka Obamacare) to guarantee funding for Navigator initiatives that help people pick the best health plans for themselves and their families. It’d also boost outreach and educational activities to raise the accessibility of information about coverage options and financial assistance to help purchase coverage. Funding for this bill would come out of the user fees imposed on participating health insurance issuers in insurance marketplaces. In each of the fiscal years 2019 through 2021, the Dept. of Health and Human Services (DHS)  would allocate $100 million of user fee revenue towards Navigator initiatives. Navigators sign up only a small fraction — under one percent — of individuals, and it’s expensive to fund navigator programs. The role that they fulfill can also be performed by agents and brokers reimbursed by health insurance plans, which is a better option that saves federal funds for other uses. SneakyPete ..... 🇺🇸🇺🇸🇺🇸🇺🇸 11*24*18 .....
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
    IntroducedOctober 30th, 2018

What is House Bill H.R. 7102?

This bill — known as the ENROLL Act — would amend the Patient Protection and Affordable Care Act (aka Obamacare) to guarantee funding for Navigator initiatives that help people pick the best health plans for themselves and their families. It’d also boost outreach and educational activities to raise the accessibility of information about coverage options and financial assistance to help purchase coverage. Funding for this bill would come out of the user fees imposed on participating health insurance issuers in insurance marketplaces. In each of the fiscal years 2019 through 2021, the Dept. of Health and Human Services (DHS)  would allocate $100 million of user fee revenue towards Navigator initiatives.

The bill’s full title is the Expand Navigators’ Resources for Outreach, Learning and Longevity (ENROLL) Act.

Impact

Health insurance consumers; uninsured individuals and families; ACA marketplaces; ACA navigator initiatives; DHS; and the ACA.

Cost of House Bill H.R. 7102

A CBO cost estimate for this bill is unavailable. However, the bill text calls for $100 million a year to fund Navigator initiatives, with funds coming from user fees collected on participating health insurance issuers.

More Information

In-Depth: Rep. Kathy Castor (D-FL) introduced this bill to secure the vital service that independent healthcare Navigators provide during ACA open enrollment:

“Families in Florida and across America have been aided every year by independent Navigators that help them find the best option for their health insurance. In Florida, over 1.7 million of our neighbors – more than any other state – signed up for a marketplace policy last year, often with the help of a Navigator. This year the President and Republicans in Congress have made it more difficult for hardworking families to sign up for affordable health care due to their sabotage, including massive cuts for national outreach and enrollment efforts. The Trump administration has slashed funding by 80 percent since 2016 for health care Navigators who help our neighbors find the best policy in the HealthCare.gov Marketplace. That is why I am introducing the ENROLL Act to safeguard the vital service health care Navigators provide to our neighbors before, during and after open enrollment… Consumers want lower costs, quality choices and a healthy insurance market and our health care Navigators can help them gain the right coverage for their needs.”

Young Invincibles, an organization aimed at amplifying young adults’ voices in the political process, supports this bill. Young Invincibles’ Director of Training and Consumer Education, Erin Hemlin, adds that the Navigator program has been a critical resource in the effort to empower and educate young people in particular:

“The ENROLL Act is an important step forward for young adults, and consumers everywhere, who need assistance enrolling in health coverage. The Trump administration’s drastic and arbitrary cuts to these programs are purely politically motivated – a cruel action intended to hurt those consumers who need help the most. Lack of awareness about coverage options, particularly financial help and deadlines, is one of the biggest barriers in reaching the remaining uninsured. If we want to help those ‘hard to reach’ populations get covered, we need to invest in making sure they know that coverage is available and accessible. The Navigator program has been a critical resource in this effort to educate and empower consumers. For young people, who are often purchasing insurance for the first time, restoring this funding would mean that they would once again get the impartial, expert guidance that only Navigators can provide, and could help those who don’t know about open enrollment and the ACA marketplace find coverage before it’s too late. When first learning about their coverage options, young people need all the information they can get, and both in-person outreach and advertising make a difference in getting them covered. Fully funding Navigator and outreach programs will vastly improve consumers’ ability to cut through the confusion and enroll in the coverage they need."

Kathy Ko Chin, president and CEO of the Asian & Pacific Islander American Health Forum (APIAHF), adds that Navigators also provide important translation and outreach services for AAPIs:

“Navigators provide an essential role to the community by providing culturally and linguistically tailored outreach for communities of color, immigrants and limited English proficient populations. Through their work, Navigators have helped to cut the uninsured rate of Asian Americans and Pacific Islanders in half under the Affordable Care Act. We applaud U.S. Reps. Castor and Blunt Rochester for introducing the ENROLL Act and for working to eliminate barriers to enrollment and ensuring that everyone has accurate information about their health insurance options.”

The Trump administration has cut funding for the Navigator program twice as part of its efforts to either do away with the ACA entirely or undermine it through defunding. Since President Trump’s inauguration in 2016, HHS has cut navigator funding by over 80 percent, leaving only $10 million to spread across the country in 2018 (versus $36 million 2017 and $63 million in 2016). Announcing the most recent budget cut in July 2018, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said it was time for the navigator program “to evolve,” and called the budget cut reflective of CMS’ commitment to the most cost-effective use of funds:

“This decision reflects CMS' commitment to put federal dollars for the Federally-facilitated Exchanges to their most cost effective use in order to better support consumers through the enrollment process.”

HHS officials in the Trump administration have repeatedly questioned the value of paying navigators, noting that such groups received $62.5 million in 2016 but signed up under 1 percent of total enrollees. According to HHS, seventeen programs enrolled under 100 consumers each, at an average cost of nearly $5,000 per enrollee.

HHS claims that agents and brokers reimbursed by health insurers can offset the loss of navigator programs; however, the Center on Budget and Policy Priorities (CBPP) points out a significant distinction between the two: agents and brokers, unlike impartial navigators who provide information about all marketplace health plan options, promote the specific plans that pay them. Additionally, the CBPP points out that navigators provide services that agents and brokers generally don’t, including helping eligible individuals enroll in Medical or the Children’s Health Insurance Program (CHIP). Finally, navigator outreach programs are specifically designed to reach vulnerable and hard-to-reach communities.

This bill has the support of one cosponsor, a Democrat. It also has the support of Young Invincibles, Community Catalyst, the APIAHF, and Planned Parenthood Federation of America.


Of NoteNavigator programs raise awareness of marketplace plans’ availability, help people apply for federal subsidies, provide impartial information about plan options, and help consumers with other important issues, including filing appeals and submitting documentation to prove their eligibility. The ACA requires all marketplaces to have navigators to help people enroll.

The Commonwealth Fund, a private foundation that seeks to promote a high-performing health care system that achieves achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, found in September 2017 that many adults remained unaware of their healthcare options under the ACA seven years after its passage. The Commonwealth Fund’s survey of 4,813 working-age adults found that 40 percent of un-insured adults were unaware of the ACA marketplaces.

The Commonwealth Fund’s survey also found that personal assistance significantly improved enrollment, particularly among people eligible for subsidies. Among adults who received personal coverage when shopping for coverage, the enrollment rate was 66 percent — 18 percent higher than the 48 percent enrollment rate among adults who didn’t receive assistance.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / vinnstock)

AKA

ENROLL Act of 2018

Official Title

To amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes.

    If need be take the money from the grossly bloated military budget. Or trumps golf trips.
    Like (195)
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    Nothing to do with Obamacare needs to be funded. It’s going to fall apart soon anyway. Joke of a policy that puts the needs of the few above the needs of the many. Idiotic to say the least
    Like (33)
    Follow
    Share
    I strongly support healthcare and the affordable care act
    Like (136)
    Follow
    Share
    Yes. Every piece of the law should be funded in full. Lack of certainty has created over conservative margin assumptions and unacceptable rate increases.
    Like (95)
    Follow
    Share
    Navigators play an important role in helping individuals navigate the Obamacare marketplace to find the best health insurance plans for themselves. They reach out to under-served communities, help people with language barriers, and provide information about subsidies — all of which improves enrollment rates.
    Like (62)
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    ON THE WAY TO A UNIVERSAL SINGLE PAYER HEALTHCARE SYSTEM.
    Like (33)
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    If patient navigator is unfunded, that provides the current administration incentive to make the navigator as complex, confusing, and frustrating as possible to provide justification for further cuts in the program.
    Like (29)
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    Absolutely!
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    Repeal Obamacare because it was and still is unconstitutional and Socialist!
    Like (26)
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    If we want to claim to be the greatest nation in the world, we need to ensure the health of its people. This is not communism. Health insurance, like the police and fire departments, like mortgages, like public education is funded by the pool of people involved, not the individual. Every kind of insurance depends on a large pool of people to drive costs down.
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    As a healthcare professional, I can advise that a healthcare plan (regardless of funding parties) cannot operate in the absence of health navigation services. It'l like buying a car with wheels. You can not have one without the other. This is a question for a subject matter expert, like a healthcare consultant, but is inappropriate for partisan influence or popular opinion.
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    👎🏻👎🏻 H. R. 7202—AKA the ENROLL Act 👎🏻👎🏻 I’m strongly opposed and do not recommend the passage of H. R.7202—AKA the ENROLL Act — would amend the Patient Protection and Affordable Care Act (aka Obamacare) to guarantee funding for Navigator initiatives that help people pick the best health plans for themselves and their families. It’d also boost outreach and educational activities to raise the accessibility of information about coverage options and financial assistance to help purchase coverage. Funding for this bill would come out of the user fees imposed on participating health insurance issuers in insurance marketplaces. In each of the fiscal years 2019 through 2021, the Dept. of Health and Human Services (DHS)  would allocate $100 million of user fee revenue towards Navigator initiatives. Navigators sign up only a small fraction — under one percent — of individuals, and it’s expensive to fund navigator programs. The role that they fulfill can also be performed by agents and brokers reimbursed by health insurance plans, which is a better option that saves federal funds for other uses. SneakyPete ..... 🇺🇸🇺🇸🇺🇸🇺🇸 11*24*18 .....
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    Yes, ACA has proven to be very beneficial and funding should continue for this specific program.
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    Anything is better than what Trump has to offer.
    Like (13)
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    Anything that improves healthcare, but honestly insurance is not affordable and the deductibles are outrageous. The affordable care act has been sabotaged. We should have a single payer system. This game is ridiculous and everyone knows it even though they’ll try to argue against it simply because THEIR political party is against and not actually look at anything pragmatically.
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    Obamacare in general needs to be destroyed. Socialized medicine ultimately hurts healthcare more than it helps. The best way to make healthcare more available and affordable is to deregulate it, open it up further to the free market and allow for competition.
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    Finding the right healthcare program can be difficult and as such should have some way of helping those that know they need health insurance but can’t really understand the jargon related to insurance...there’s plenty of places that we can get the money to fund this...I can think of several off the top of my head....like maybe NOT doing a military parade...the world doesn’t need to see what’s in our arsenal more than they already do
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    And the ACA should be strengthened. Why don’t repugs want everyone to have access to health care?? I really don’t understand them. Plenty of money for $millions in tax cuts for the wealthy but try to get them to fund healthcare for those that need help. Truly a headshaker.
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    The more we support efforts to help people find and purchase affordable health care, the better our country will be in the long run: fewer chronically ill, less emergency room medicine, and shorter hospital stays. It only makes common sense to fund patient navigator programs according to how many people they help. If they aren't helping enough people, then give the funding to ones who are. But don't take away this service.
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    Uninsured people COST MONEY! An an RN who works with an uninsured and underinsured population, the cost of hospitalizing people for preventable disease is something I see on a daily basis. The financial expense of these types of hospitalizations in addition to the loss of days worked (which means a loss of productivity and income for the community) is destructive. Helping people obtain insurance and utilize less expense treatment benefits everyone.
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