CMS Announces Even Deeper Navigator Cuts

The less information people have, the sooner they die......

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On July 10, 2018, the Centers for Medicare and Medicaid Services (CMS) released a new funding opportunity announcement for the navigator program for 2019, as well as a series of frequently asked questions and an overview of the application process. This funding is for navigators in the 34 states with a federally facilitated marketplace; states with their own marketplaces or partnership marketplaces can invest additional resources in navigator and other outreach and education programs.

Consistent with press reports, CMS will cut navigator funding to only $10 million for 2019. This is down from $36.8 million for the 2018 plan year (which was, itself, cut from about $63 million for the 2017 plan year). Since the Trump administration took office in January 2017, the navigator program has been cut by about 84 percent. CMS is scaling back the navigator program due to what it believes is heightened public awareness of the marketplace and new coverage options.

Navigators will be required to prioritize assistance to uninsured individuals who are unaware of their coverage options through the marketplace, or through association health plans or short-term plans. CMS repeatedly emphasizes the need for navigators to reach this community, which it refers to as the “left behind” population.

Applications are due quickly, on August 9th. CMS expects to award 25 to 50 grants that will range from $100,000 to up to $1.25 million per state. Grant awards will be announced on September 12th.

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