States See Challenges in Hiring 'Navigators' for Health Plan Exchanges


Officials in many states say they are bracing for challenges in hiring tens of thousands of workers -- required under the Affordable Care Act -- to help consumers navigate their way through the new health insurance marketplaces when they open later this year, the Washington Post reports.

About the 'Navigators'

The ACA requires the insurance exchanges -- which are scheduled to accept applications in October and begin operating next January -- to provide "navigators" for any applicants who need help with the enrollment process.

The costs to hire the navigators over the short term can be offset by federal grants, state budgets or private funding, but over the longer term, the bulk of the costs must be covered by the marketplaces, according to the Post. Such money will come from fees charged to health plans participating in the exchanges, the Post reports.

Denise de Percin -- executive director of Consumer Health Initiative in Colorado -- said the assisting staffers are necessary to help consumers sift through potentially complex information. In addition, many of those who might enroll in the marketplaces could face difficulties reading or understanding English and the explanations about copayments, deductibles and subsidies, de Percin said.

States' Plans

Several states already have announced an approximate number of navigators that they will need. For example:

  • Arkansas plans to hire about 535 workers;
  • California plans to hire and deploy about 21,000 helpers; and
  • Maryland expects to have a total of 400 staffers, 250 of whom the state hopes to pay for using federal funding grants.

Some states also are facing political hurdles. For example, insurance brokers are lobbying for regulations that would prohibit navigators from providing guidance on selecting health plans or making them liable if their advice results in financial harm.

According to the Post, some states are considering or have passed legislation to impose strict standards on the workers. Proposals being considered in Virginia, Ohio and Utah are aimed at:

  • Prohibiting navigators from advising consumers about selecting health plans;
  • Requiring navigators to obtain a state license; and
  • Requiring the workers to post surety bonds to cover any liability if they dispense bad advice.

Maine and Iowa already have passed such measures, the Post reports (Aizenman,Washington Post, 2/4).

Michael Small
I am an attorney with ERISA, Insurance and Healthcare issues experience. I have attended conferences and taken Insurance CE courses on the ACA. I offered my services on a voluntary basis, and did not even receive a call or note. After attending a Board Meeting this week, it is clear that the work was done by Nevada's contractor, Xerox, and the Navigators don't want someone looking over their shoulder.
julie olguin-molina
The navigator positions needed to help clients clients connects with needed services is a huge opportunity to enroll Social Workers. Social workers interact with systems and can handle management and education on the frontlines. They can also help everyone to understand the new health care policies. i.e. "they stitch everything together" (patient and institutions.)
Cindy Tran
From this article, it seems as if the 'state will be hiring' navigators as state employees. Does anyone know if the navigators will be state employees or if the state will subcontract or give grants to local organizations to hire their own navigators? Thanks!
Margaret Hanford
Look folks, these agents are driving up the cost for health insurance. If we all have to pay for them unnecessarily anyway, might as well pay for them through welfare benefits until they can get the training for a REAL job where they don't have to leech off innocent, unsuspecting people. Since when do agents give the BEST advice as opposed to whatever advice drives up their commission? It's their fault we can't get single-payer, theirs and their lobbying friends. Navigators will come from existing groups in existing communities - ever hear of promotoras and Certified Application Assistants? If you don't like navigators, give us single-payer! Otherwise, NO COMMISSIONS!
Colleen King
This whole system isn't making a lot of sense--The State is going to create a web site where people can go to check out and compare plans. Then, they will have a bunch of people, who probably won't need E&O because they're state employees, to 'help' figure out the plans and which they should apply to. Isn't that basically what the agent community already does? Why not strengthen the agent community, where they don't get paid if they don't produce, rather than create another bureaucracy where office space, salaries and benefits have to be paid for?

to share your thoughts on this article.