This legislation amends the Patient Protection and Affordable Care Act to significantly enhance the Navigator program , which assists consumers with health insurance enrollment. It expands the scope of navigator duties to include providing information and assistance for State Medicaid plans and State Children's Health Insurance Programs (CHIP) , in addition to Qualified Health Plans. Navigators will also be required to conduct public education activities in plain language to raise awareness of QHP requirements and protections, with these duties permitted throughout the year. For federal exchanges, the bill establishes new requirements for selecting grant recipients, mandating awards based on an entity's demonstrated capacity and ensuring at least one grant annually goes to a community and consumer-focused nonprofit group . A crucial new provision requires navigators to maintain a physical presence within the State of the Exchange to facilitate in-person assistance for consumers, aiming for more direct and accessible support. To bolster the federal navigator program, the legislation obligates $100,000,000 annually for fiscal year 2026 and subsequent years, sourced from user fees on participating health insurance issuers. These amendments, reinforcing the program's resources and reach, are set to apply to plan years beginning on or after January 1, 2026.
This legislation amends the Patient Protection and Affordable Care Act to significantly enhance the Navigator program , which assists consumers with health insurance enrollment. It expands the scope of navigator duties to include providing information and assistance for State Medicaid plans and State Children's Health Insurance Programs (CHIP) , in addition to Qualified Health Plans. Navigators will also be required to conduct public education activities in plain language to raise awareness of QHP requirements and protections, with these duties permitted throughout the year. For federal exchanges, the bill establishes new requirements for selecting grant recipients, mandating awards based on an entity's demonstrated capacity and ensuring at least one grant annually goes to a community and consumer-focused nonprofit group . A crucial new provision requires navigators to maintain a physical presence within the State of the Exchange to facilitate in-person assistance for consumers, aiming for more direct and accessible support. To bolster the federal navigator program, the legislation obligates $100,000,000 annually for fiscal year 2026 and subsequent years, sourced from user fees on participating health insurance issuers. These amendments, reinforcing the program's resources and reach, are set to apply to plan years beginning on or after January 1, 2026.