Home » Blog » The Navigator Program Revealed

The Navigator Program Revealed

The California Health Benefit Exchange, arguably the most novel and exciting component of federal health reform, aims to enable as many as four million California individuals and small businesses to easily and meaningfully compare health plans and find affordable insurance products.

Because outreach to, education for, and enrollment of those eligible for the Exchange will be, at best, an enormous challenge, the ACA included one new model to assist states in this effort: the Navigator Program.

Recipients of Navigator grant funding may be public or private entities and must have relationships with employers and employees, consumers or self-employed individuals likely to be eligible for plans in the Exchange.

According to the ACA, Navigators grantees must:

  • Make available information that is fair, accurate and impartial;
  • Conduct public education activities to raise awareness of plans in the Exchange;
  • Facilitate enrollment in qualified health plans;
  • Provide referrals for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage; and
  • Provide culturally and linguistically appropriate information for the population being served by the Exchange.

In conjunction with our colleague Micah Weinberg at the New America Foundation, we recently wrote this Navigator Backgrounder that summarizes the ACA law on the Navigator Program and offers various perspectives on its design and structure.

We are expecting more federal guidance on the Navigator Program in the next two to three months which should provide additional visions of and restrictions on the ways that states’ Navigator Programs may work. One of the first tasks for the Board of the California Health Benefit Exchange will then be to design the program for effective implementation here in California.