WASHINGTON, DC - Energy and Commerce Committee Republican Leader Greg Walden (R-OR), Health Subcommittee Republican Leader Dr. Michael Burgess (R-TX), and Oversight and Investigations Subcommittee Republican Leader Brett Guthrie (R-KY) are raising concerns to the Centers for Medicare and Medicaid Services (CMS) about the Navigator program established under the Affordable Care Act.
The Navigator program was intended to provide consumer outreach and enrollment assistance for the health insurance exchanges. However, examinations of navigators by the Energy and Commerce Committee have uncovered serious concerns about wasteful spending of taxpayer dollars and the effectiveness of the program. Today, the Republican leaders sent a letter to CMS Administrator Seema Verma to express those concerns.
“We have been examining the Navigator program and its effectiveness since it was established. During this work, we have identified implementation challenges and wasteful spending of taxpayer dollars," the leaders wrote. “More recent reviews of the Navigator program have also found that the program has been an ineffective and inefficient use of limited government resources. For instance, for plan year 2017, navigators were awarded $62.5 million in grants and enrolled 81,426 individuals - which amounts to $767 per person."
In their letter, the leaders highlight repeated reports of navigators not meeting their enrollment goals set each year. In one instance, according to CMS, one grant recipient in the Navigator program had an enrollment goal of 2,000 individuals for the 2017 plan year, yet only enrolled one person.
To strengthen program oversight and accountability, CMS revised the funding structure of the program. In 2017, CMS announced that it would start awarding funding to navigators based on their ability to meet their enrollment goals for the previous year.
On Aug. 30, 2019, CMS awarded 34 organizations a total of $10 million to serve as navigators. The leaders raise concern about this funding and the efficacy of the program, and request a briefing from CMS by November 5, 2019 about the Navigator program.
“Given the flawed history of the Navigator program, we have questions about this funding and the overall role of navigators," the leaders write.
