HR 3907119th CongressIn Committee

ENROLL Act of 2025

Introduced: Jun 11, 2025

Education

Standard Summary

Comprehensive overview in 1-2 paragraphs

The ENROLL Act of 2025 would broaden and fund the ACA’s navigator program. Key changes require exchanges (including those operated by HHS in states) to prioritize grant recipients based on their capacity to carry out expanded duties, add Medicaid and CHIP information to navigator responsibilities, and requireplain-language public educación about qualified health plans. It also introduces an in-person presence requirement for navigators, and creates a dedicated funding stream of $100 million per year (from health insurer user fees) for federal exchanges to carry out the navigator program starting in fiscal year 2026. The changes take effect for plan years beginning January 1, 2026. In short, the bill aims to expand navigator outreach, deepen information about more coverage options (QHPs, Medicaid, CHIP), ensure a more community-focused and in-person navigator presence, and guarantee robust, dedicated funding to sustain the program.

Key Points

1Selection of navigator grant recipients:
2- Exchanges must award grants based on an entity’s demonstrated capacity to perform the specified duties.
3- The grant process cannot rely on an entity’s plan to provide information about non-qualified health plan group health options.
4- Each year, at least one grant must go to a community- and consumer-focused nonprofit group.
5Expanded navigator duties (Section 1311(i)(3)):
6- Add information and outreach about State Medicaid plans (Title XIX) and State CHIP programs (Title XXI) alongside qualified health plans.
7- Include additional duties to conduct public education activities in plain language to raise awareness of QHP requirements and protections.
8- Allow these duties to be carried out by navigators at any time during the year.
9In-person assistance requirement:
10- Navigators must maintain physical presence in the state of the Exchange to provide in-person help to consumers.
11Funding for federal exchanges:
12- For purposes of carrying out the navigator duties, the Secretary must obligate $100 million per fiscal year (starting with FY 2026) from user fees on participating issuers (as per 45 CFR 156.50).
13- The funding amount remains available until expended.
14Effective date:
15- Provisions apply to plan years beginning on or after January 1, 2026.

Impact Areas

Primary group/area affected- Individuals and families seeking health coverage through Exchanges (QHPs) and those eligible for Medicaid or CHIP who use navigators.- Community- and consumer-focused nonprofit organizations that sometimes serve as navigator partners.Secondary group/area affected- State and Federal Exchanges (including those operated by the Secretary under 1321(c)).- Health insurance issuers that fund the navigator program through user fees.Additional impacts- Increased emphasis on in-person, local assistance may improve access for rural or underserved populations but could raise operational costs for navigators.- Stronger coordination across QHP, Medicaid, and CHIP information may improve enrollment decisions and awareness of protections.- The dedicated $100 million annual funding to federal exchanges could stabilize navigator resources but ties funding to issuer-fee revenue and federal administration.

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