The Centers for Medicare and Medicaid Services (CMS) recently announced the availability of $60 million in grant funding for Navigators in the Federally-Facilitated Marketplaces (FFM) and State Partnership Marketplaces (SPM) (sometimes referred to as Exchanges). Navigators are specially trained individuals or organizations that provide unbiased information about health insurance options and assist people in completing eligibility and enrollment forms.
People experiencing homelessness may face a range of barriers to obtaining Medicaid or private health insurance, and frequently needed specialized assistance and support to go through the enrollment process. Barriers for people who are homeless may include:
- Single non-elderly adults, particularly those with substance use issues, have traditionally been deemed categorically ineligible for Medicaid, because their impairments and/or addiction were not deemed to be qualifying disabilities
- Other single, non-elderly adults who might have qualified for Medicaid on the basis of their mental health problems have gone without insurance rather than agreeing to a diagnosis of mental illness, and the stigma that still sometimes accompanies that label
People experiencing homelessness may face literacy, language, transportation, and income or disability documentation issues that make completion of the eligibility/enrollment process difficult
Some people experiencing homelessness are distrustful of public and bureaucratic systems
It is also vital to address the obstacles persons living with HIV/AIDS (PLWHA) may experience in obtaining appropriate coverage. Those who are diagnosed with HIV should be connected to health care as soon as possible so that their infection can be virally suppressed. Navigators will play an integral role in bridging the gap between PLWHA and quality health care.
Both homeless and HIV/AIDS housing and service providers are well positioned to assist people experiencing homelessness and/or serious health challenges to overcome these types of barriers, and, as described below, should consider applying for Navigator grant funding. Specifically, housing and service providers are in unique positions to develop and sustain the personal relationships that are frequently necessary to educate people about the benefits of health insurance/Medicaid coverage, and to facilitate their application and enrollment process.
Two types of applicants, including at least one community and consumer-focused nonprofit, will receive Navigator grant awards in each state with a Federally Facilitated Marketplace (FFM) or State Partnership Marketplace (SPM). Eligible entities, individuals, and consortia applying for Navigator funding must commit to assisting the full range of consumers in their state.
Homeless and HIV housing and service providers operating in States with a FFM/SPM should consider applying for Navigator grant funding. This could be done by partnering with other entities and/or individuals to form a consortium which serves a large total portion of the population.
To find out if your state participates in a FFM or SPM, visit the Affordable Care Act State and Territory Profiles located on HUD’s OneCPD Resource Exchange website or visit HealthCare.gov. An important next step in deciding to apply to become a Navigator is learning more about the requirements applicable to Navigators. CMS recently finalized regulations that outline the Navigator program standards and other requirements.
Applications are due by July 10, 2014.
To access the funding opportunity announcement, visit Grants.gov and search for CFDA #93.332.