5 Things to Know About PPACA Health Insurance Marketplace Assister Programs

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Under the Patient Protection and Affordable Care Act, state health insurance exchanges must establish navigator or assister programs to aid consumers in learning about their options, applying for financial assistance and enrolling in health plans.

In late April and early May, the Kaiser Family Foundation surveyed 843 assister programs operating in both state-based and federally run marketplaces. The programs studied included navigators, certified application counselors, federally qualified health centers, in-person assisters and federal enrollment assistance programs. Here are five things to know from the Foundation's findings.

1. During the first PPACA open enrollment period, more than 4,400 assister programs aided approximately 10.6 million people.

2. Assistance resources were not evenly distributed. For instance, there were roughly twice as many assisters available per 10,000 uninsured people in states with state-based marketplaces and consumer assistance partnership marketplaces than there were in states with federally facilitated marketplaces.

3. More than 80 percent of the assister programs reported most or almost all consumers who sought help didn't understand the PPACA or their coverage choices, or just didn't have the confidence to apply independently. Additionally, 90 percent of the programs surveyed have already been re-contacted by people with enrollment questions and issues, such as not receiving insurance cards.

4. Three-quarters of programs report they will very likely to provide assistance during next year's open enrollment period as well. If this trend continues, assisters could develop into PPACA marketplace experts, according to the Foundation.

5.  Because public understanding of the PPACA is limited and the most resourceful and motivated people likely enrolled during the first year, assister programs will likely play an even more important role in enrollment and coverage growth in 2015 and beyond, according to the Foundation.

More Articles on the PPACA:
Medicaid, CHIP Enrollment Up 11.4% Since PPACA Rollout
Survey: Rate of Uninsured Falls to 15%
Robert Wood Johnson Foundation Establishes PPACA Impact Monitoring Project 

 

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