Consumer Assistance in Federal Marketplace States

The ACA is new and unfamiliar to consumers, and those in federally facilitated marketplace (FFM) states in particular may be confused about whom to contact with questions. In FFM and partnership (SPM) states most consumer assisters are federally selected and funded, so there could be potential disconnects between federal navigators and state consumer resources. However, some states are working creatively with these entities to ensure that consumers have the information and assistance they need when applying for new coverage.
Consumer assistance programs that support the ACA include navigators, in-person assisters (IPAs), certified application counselors (CACs), agents and brokers and certain federally qualified health centers. The consumer assistance landscape in a particular state will vary somewhat depending on which marketplace model the state has chosen. For more information on the various programs, Enroll America has an informative fact sheet.
Below we highlight some state examples of how SPM and FFM states can support the work of consumer assisters to ensure their residents can access high-quality enrollment assistance. Illinois developed training to help navigators understand state-specific issues, while Kansas and Nebraska are providing consumers with information about their options and where they can find assistance.
Illinois: State-specific requirements and training

• Illinois partnered with the School of Public Health at the University of Illinois at Chicago (UIC) to develop state-specific training for IPAs, drawing on UIC’s experience with health administration, insurance and connections with other organizations. In conjunction with UIC, the state developed a three-day training schedule: one day of online training, followed by two days of in-person training. The curriculum also includes general information about the ACA for assister organizations that may be new to health care. Both navigators and assisters are required to complete the three-day training, while CACs are required to complete a modified online version of about six hours.
• llinois has also integrated federal navigators into the activities and processes developed for their state in-person assister grantees by distributing relevant policy guidance and outreach tools to navigators and including them in weekly webinars with IPAs. Also, regional outreach coordinators, who are employed by the state to monitor enrollment activity and consumer education efforts, are assigned to support both IPAs and navigators.

​Kansas: Online tools for consumers and assisters

• The Kansas Insurance Department (KID) is a part of the Kansas Marketplace Consortium led by the Kansas Association for the Medically Underserved, a navigator grant awardee. Through this partnership and by coordinating with issuers, the department has developed a directory of navigators, brokers and CACs that are available to Kansans on their state-specific website. The site also has a tax credit calculator that incorporates the actual cost of the second lowest cost silver plan, adjusted for age and region. You can read more about the website in our previous blog post. These tools are helpful not only to consumers, but also to agents/brokers and navigators working in the state. The KID has also held fourteen in-person appearance events around the state to educate consumers, with navigators and issuers participating at some of the events. Finally, the KID has developed a statewide calendar of navigator-led events that is updated weekly.

Nebraska: Online information and tools to link consumers with assisters

• The Nebraska Department of Insurance (DOI) has developed an informational website about the marketplace, including a glossary of terms, frequently asked questions and details about options for individuals and small businesses under the ACA. The DOI requires navigators and other consumer assistance entities receiving federal money for enrollment assistance activities to register with the state. The resulting registration database has allowed the DOI to create alist of approved navigators in the state, including names and addresses, so that consumers are able to easily find assistance. The state agency also plans to provide a list of FFM-certified brokers available once HHS releases that information.

Is your state coordinating with the various types of in-person assisters or developing tools to aid consumers and enrollment assisters? Tell us in a comment below.