Sponsors (2)
Last progress June 11, 2025 (8 months ago)
Introduced on June 11, 2025 by Kathy Castor
Referred to the House Committee on Energy and Commerce.
ENROLL Act of 2025
Updated 2 days ago
Last progress June 11, 2025 (8 months ago)
Changes the federal navigator program for Health Insurance Marketplaces run by the Secretary by setting rules for who gets navigator grants, what navigators must provide, and how much must be funded each year. It requires the federal Exchange to select grantees based on demonstrated capacity, fund at least one community-focused nonprofit annually, provide plain‑language public education about qualified health plans, maintain an in‑state physical presence for in‑person help, and obligate $100,000,000 each fiscal year from issuer user fees for these grants. These requirements apply to plan years beginning on or after January 1, 2026. The aim is to strengthen outreach and in‑person assistance for consumers enrolling in qualified health plans on federal Exchanges and to ensure predictable grant funding through issuer user fees.
Amends section 1311(i) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(i)).
When an Exchange established and operated by the Secretary within a State (per section 1321(c)) awards navigator grants, the Exchange must select entities based on the entity’s demonstrated capacity to carry out each of the duties specified in paragraph (3).
The Exchange awarding grants must not take into account whether the entity has demonstrated how it will provide information to individuals about group health plans that are not qualified health plans.
Each year the Exchange must award at least one navigator grant to an entity that is a community and consumer‑focused nonprofit group.
Adds a duty (new subparagraph (F)) requiring navigators to conduct public education activities in plain language to raise awareness of the requirements of and protections provided under qualified health plans.
Who is affected and how:
Federal Exchange administrators: Must change grant selection, oversight, and ensure annual obligations of funds. They will need procedures to document grantee capacity, track community nonprofit funding, and verify in‑state physical presence for in‑person help.
Navigator organizations and prospective grantees (especially nonprofits): Organizations that apply for navigator grants must demonstrate capacity to do outreach and enrollment. Community‑focused nonprofits have a guaranteed pathway to at least one funded slot each year, increasing opportunities for locally based groups.
Consumers and people seeking coverage: People shopping for or enrolling in qualified health plans on federal Exchanges should see more plain‑language education and better access to in‑person assistance in their state, which may improve understanding and enrollment outcomes.
Health insurance issuers (insurers): Issuers will fund the $100 million annual obligation through issuer user fees charged by the Exchange. This could raise issuer costs or reallocate existing fee resources and may indirectly affect issuer administrative budgets.
Federal budget and program administration: The requirement to obligate $100 million yearly from issuer user fees creates a predictable funding stream dedicated to navigator grants. Because funds are specified to come from issuer user fees, the provision does not appropriate general Treasury funds but directs the Exchange to use collected user fees for grants.
Overall effect: The change strengthens federal Exchange outreach and in‑person assistance by tying dedicated, recurring funding to navigator grants and by prioritizing community organizations and plain‑language education. It shifts or specifies funding responsibility to issuer user fees and requires administrative changes by federal Exchange operators and grantees.