LISTEN: The Centers for Medicaid and Medicare Services is disbursing $80 million in funding to help more people across the nation enroll in health insurance. It’s the largest-ever federal funding pool set aside for health insurance navigators. GPB’s Sofi Gratas reports on how much Georgia is getting. 

Close-up of African American teenage boy having a session with mental health professional at counselling center.

The Centers for Medicaid and Medicare Services is disbursing $80 million in funding — the largest-ever federal funding pool set aside for health insurance navigators to aid people in getting insured.

Three organizations in Georgia will receive about $2.7 million dollars this year to hire and support “certified navigators,” agents that help uninsured people understand and get enrolled in a marketplace health insurance plan.

The marketplace opened in 2013 as part of the Affordable Care Act, which became law during the Obama administration. Since 2020, enrollment in a marketplace insurance plan in Georgia has almost doubled, with over half a million people enrolled this year.

This second installment of the grant, approved by the Biden administration in 2021, goes for three years. 

Cathy Hawkins works for the Georgia Primary Care Association, which represents the state’s federally qualified health care centers. This year it has $2.5 million dollars from the grant to spend on expanding its navigator program statewide. 

“Without navigators, you won't have as many consumers enrolling — period,” Hawkins said.

Hawkins said the GPCA targets uninsured minorities, low-income and houseless groups and people eligible for Medicaid who don’t know it.  

Funding for navigators dropped by 80% during the Trump administration. Hawkins said during that dip in funding, GPCA could not afford as many navigators on staff. 

“But we were still able to do our job,” Hawkins said, meaning outreach efforts through community partners, such as social services and housing agencies, continued. 

Federal regulatory standards for navigators also changed under the Trump administration. Previously, at least two navigator agencies were required per state and had to maintain a physical presence. These rules have not been restored. 

Cynthia Gibson with the Georgia Legal Services Program said their share of the grant, about $490,000, will continue to fund five navigators specifically working in areas that serve neighboring rural counties.

But outreach isn’t always successful, she said. 

“The biggest hurdle we have seen in getting people enrolled is they don’t think they need it,” Gibson said. “You never know when you’re going to need it.” 

She said encouraging young people to enroll in health insurance is especially difficult because they often don’t want to pay monthly premiums, even if they qualify for an advanced payment tax credit which lowers premiums based on household income.  

Even if they do get enrolled, keeping people on marketplace insurance or getting them to re-enroll is another job navigators are responsible for. 

“A lot of times consumers are intimidated because whether they know how to use technology or not, they're just intimidated by that process and may not follow through,” Hawkins said. “It's important for the navigators to help consumers obtain assistance for post enrollment problems. … We close the loop. We close the gap.”

St. Joseph’s Mercy Care Services in Fulton County is the third recipient of the grant with $170,000 to spend on a navigator program targeting people experiencing homelessness in metro Atlanta.

Tags: Center for Medicare and Medicaid Services  health care access  health insurance  Health and Human Services  Georgia  Macon  Savannah  Atlanta