Health Exchanges 2013: Rise of the Navigators

Health care enrollment will become a lot easier with the arrival of the Exchanges. States across the nation are busy developing their Exchange with or without the partnership of the federal government. Other states have chosen the route to create their own state Exchanges will put together the subsidiary Exchanges that are essentially smaller Exchanges within the same state. In order to ensure that Exchanges don’t confuse the consumers and avoid any misunderstanding, the Exchange authorities are endorsing the creation of Navigator Programs.

State lawmakers have been continuously seeking more guidance from the federal government regarding the Exchange programs, where they are asking for suggestions about how to take the Exchange to the masses and to ensure there is better connectivity between the Exchange selling format and the uninsured. There is also a need to explain the special features about the Exchange such as the presence of a Shop Exchange that will be dedicated to the insurance buying requirements of the employers.

According to most estimates, between 25 and 30 million people are expected to gain health care enrollment via the Exchange insurance programs. This means that consumers are going to demand a lot about the vast number of plans that will be listed on the Exchanges. Thus, the state authorities are calling for the navigator program where professionals will be in charge of providing information to the people about the assortment of insurance plans apart from providing standard information like the Medicare application process or the out-of-pocket expenses by using the insurance quote engine built within the web-enabled Exchange.

Navigators are gaining importance as both the consumers and the insurers realize their importance apart from the state authorities who realize that in order to break across the traditional barriers to not having health insurance, they need the navigators to be penetrative and informational without being biased. Navigators can be understood as people who have been mandated as a part of the Affordable Care Act. The federal government has been providing guidance about how to recruit, train and deploy navigators for mitigating any kind of potentially-confusing scenarios that might arise for the Exchange-using consumers.

States authorities have realized that despite the presence of automated features like a Medicare quote engine they would need people to provide individual guidance about common questions like how to get the Medicare eligibility-enrollment correct. This is why states like California have been proactive in starting the recruitment and training of navigators. It should be noted that there is a basic difference between the navigator and assister program. The assisters should be qualified, financial or actuarial professionals, including brokers and agents. They would not be paid by the state authorities running the Exchanges. Their income will come from commissions earned from the insurers. Navigators will be employed by the state Exchanges. For some time after the launch of state Exchanges, the federal government might fund the navigators but eventually they would have to be employed directly by the state’s Exchange authorities.