ENROLL Act of 2025
The ENROLL Act of 2025 would overhaul the ACA’s navigator program. It changes how grant recipients are selected, broadens the duties navigators must perform (including information about Medicaid and CHIP and mandatory plain-language public education), and requires navigators to maintain in-person, physical presence in the exchange state. The bill also requires that at least one community-focused nonprofit receive a grant each year and secures funding for federal exchanges—$100 million annually starting in fiscal year 2026, drawn from health insurer user fees. The provisions would take effect for plan years beginning January 1, 2026. In short, the bill aims to strengthen consumer outreach and in-person assistance, expand the scope of information navigators provide, and ensure sustained federal funding for the program.
Key Points
- 1Selection of grant recipients: Exchanges must award grants based on an entity’s demonstrated capacity to carry out specified navigator duties, and must ensure at least one community and consumer-focused nonprofit receives a grant each year; they must not factor in whether an entity will provide information about nongrand health plans.
- 2Expanded duties: Navigators must include information about State Medicaid plans and State CHIP programs, add a public education obligation in plain language about QHPs’ requirements and protections, and can carry out these duties at any time during the year.
- 3In-person assistance requirement: Navigators must maintain physical presence in the Exchange’s state to provide in-person consumer help.
- 4Funding for federal exchanges: For plans administered by the Secretary in a State under 1321(c), the Secretary must obligate $100 million per fiscal year (starting with FY 2026) from insurer user fees, with the funds remaining available until expended.
- 5Effective date: Changes apply to plan years beginning on or after January 1, 2026.