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States See Challenges in Hiring ‘Navigators’ for Health Plan Exchanges

Officials in many states say they are bracing for challenges in hiring tens of thousands of workers -- required under the Affordable Care Act -- to help consumers navigate their way through the new health insurance marketplaces when they open later this year, the Washington Post reports.

About the 'Navigators'

The ACA requires the insurance exchanges -- which are scheduled to accept applications in October and begin operating next January -- to provide "navigators" for any applicants who need help with the enrollment process.

The costs to hire the navigators over the short term can be offset by federal grants, state budgets or private funding, but over the longer term, the bulk of the costs must be covered by the marketplaces, according to the Post. Such money will come from fees charged to health plans participating in the exchanges, the Post reports.

Denise de Percin -- executive director of Consumer Health Initiative in Colorado -- said the assisting staffers are necessary to help consumers sift through potentially complex information. In addition, many of those who might enroll in the marketplaces could face difficulties reading or understanding English and the explanations about copayments, deductibles and subsidies, de Percin said.

States' Plans

Several states already have announced an approximate number of navigators that they will need. For example:

  • Arkansas plans to hire about 535 workers;
  • California plans to hire and deploy about 21,000 helpers; and
  • Maryland expects to have a total of 400 staffers, 250 of whom the state hopes to pay for using federal funding grants.

Some states also are facing political hurdles. For example, insurance brokers are lobbying for regulations that would prohibit navigators from providing guidance on selecting health plans or making them liable if their advice results in financial harm.

According to the Post, some states are considering or have passed legislation to impose strict standards on the workers. Proposals being considered in Virginia, Ohio and Utah are aimed at:

  • Prohibiting navigators from advising consumers about selecting health plans;
  • Requiring navigators to obtain a state license; and
  • Requiring the workers to post surety bonds to cover any liability if they dispense bad advice.

Maine and Iowa already have passed such measures, the Post reports (Aizenman,Washington Post, 2/4).

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