ENROLL Act of 2025
- Bill Number
- S. 2024
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-06-11: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- Last Updated
- 2025-12-05T06:26:22Z
AI-Generated Summary
Purpose
The ENROLL Act of 2025 aims to strengthen the navigator program under the Affordable Care Act (ACA) by expanding eligibility criteria for grant recipients, broadening the duties of navigators to include education on Medicaid and Children's Health Insurance Program (CHIP) options, requiring in-person assistance, and providing dedicated funding for federally facilitated health insurance exchanges. Navigators are trained helpers who assist consumers in enrolling in health coverage through ACA marketplaces.
Key Provisions
- Selection of Navigator Grant Recipients: For federally facilitated exchanges (operated by the federal government in states that do not run their own), grants must be awarded based on an entity's ability to perform required duties. Selection cannot consider whether the entity provides information on employer-sponsored group health plans outside the ACA marketplace. At least one grant per year must go to a community- or consumer-focused nonprofit organization.
- Expanded Duties of Navigators:
- Provide information and assistance on qualified health plans (ACA marketplace plans), as well as state Medicaid programs (health coverage for low-income individuals) and CHIP (coverage for children in low-income families).
- Conduct public education activities in simple, everyday language to raise awareness of ACA plan requirements and consumer protections.
- Perform these duties at any time during the year, not just during open enrollment periods.
- Operational Requirements: Navigators must maintain a physical office or presence in the state of the exchange to offer in-person help to consumers. The bill also adjusts rules on potential conflicts of interest, clarifying that navigators cannot be health insurance issuers or their affiliates, and cannot receive consideration from them in exchange for steering consumers toward specific plans.
- Funding: Allocates $100 million annually starting in fiscal year 2026 for navigator grants in federally facilitated exchanges, drawn from fees paid by participating health insurance companies. These funds remain available until spent.
Significant Changes to Existing Law
- To ACA Section 1311(i): Previously, navigator selection focused more broadly without mandating nonprofit inclusion or excluding consideration of non-ACA group plans. Duties were limited to ACA plans and mainly occurred during enrollment periods; the bill extends them year-round and to Medicaid/CHIP.
- Conflict and Presence Rules: Tightens prohibitions on ties to insurance companies and introduces a new requirement for physical in-state presence, which was not previously mandated.
- Funding Mechanism: Shifts to a dedicated annual obligation from insurer user fees for federal exchanges, providing more stable and increased support compared to prior discretionary grants.
Potential Impacts
- On Government Agencies: The Department of Health and Human Services (HHS) will need to manage the new $100 million annual funding stream and oversee expanded navigator activities, potentially increasing administrative workload but improving outreach efficiency in federally facilitated exchanges (covering about two-thirds of states).
- On Citizens: Enhances access to clear, in-person assistance for enrolling in health coverage, particularly benefiting low-income individuals, families, and underserved communities who may struggle with online-only or complex enrollment processes. Year-round education could reduce uninsured rates by raising awareness of protections like no denial for pre-existing conditions.
- On International Relations: No direct impacts, as the bill focuses on domestic health policy.
Main Stakeholders Affected
- Consumers and Enrollees: Individuals seeking ACA, Medicaid, or CHIP coverage, especially in rural or low-resource areas, who gain from expanded, in-person, and year-round support.
- Navigator Organizations: Nonprofits and community groups eligible for grants, which now have clearer selection paths and more funding opportunities.
- Health Insurance Issuers: Indirectly affected through user fees funding navigators and restrictions on influencing navigator recommendations.
- State and Federal Governments: States with their own exchanges see minimal changes, while federal exchanges (HHS-operated) face new funding and oversight duties.
Notable Legal, Constitutional, or Political Implications
- Legal: Reinforces the ACA's framework without altering core structures, but the dedicated funding from user fees could face challenges if seen as an unfunded mandate on issuers; complies with existing grant authority under the ACA.
- Constitutional: No apparent issues, as it involves congressional spending power and regulation of interstate commerce in health insurance, consistent with ACA precedents upheld by the Supreme Court.
- Political: Builds on the ACA by investing in outreach amid ongoing debates over its expansion; sponsored by Democratic senators, it may highlight partisan divides on health reform, potentially aiding enrollment goals but drawing criticism for increasing federal spending. Effective for plan years starting January 1, 2026, allowing time for implementation.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (10)
Sen. Shaheen, Jeanne [D-NH], Sen. Merkley, Jeff [D-OR], Sen. Luján, Ben Ray [D-NM], Sen. King, Angus S., Jr. [I-ME], Sen. Wyden, Ron [D-OR], Sen. Booker, Cory A. [D-NJ], Sen. Duckworth, Tammy [D-IL], Sen. Klobuchar, Amy [D-MN], Sen. Welch, Peter [D-VT], Sen. Murphy, Christopher [D-CT]
Recent Actions
- 2025-06-11: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 2025-06-11: Introduced in Senate
Bill Versions
- Expand Navigators’ Resources for Outreach, Learning, and Longevity Act of 2025 — issued 2025-06-11 — PDF (5 pages)