By Joe Gardyasz


With just 45 days remaining until state electronic marketplaces, or exchanges, begin enrolling uninsured individuals and small businesses in health insurance plans, the "navigators" who will assist people in Iowa have yet to complete the required training.


The U.S. Department of Health and Human Services announced on Thursday it has awarded $67 million to 105 organizations in 34 states, including $600,000 to three organizations that will deploy navigators in Iowa. Those organizations designated to provide navigators are Genesis Health System, Planned Parenthood of the Heartland and Visiting Nurse Services of Iowa.


Visiting Nurse Services of Iowa, which was awarded a grant of $257,142, plans to implement a navigator program serving 38 counties, which are home to approximately half the state's uninsured population. Planned Parenthood of the Heartland, which received a $214,427 grant, said it plans to cover 61 Iowa counties and strategically base navigators in regions across the state.


However, those navigators will first have to be trained.


Iowa legislators enacted a bill last year requiring navigators to be licensed by the state and pass an examination. To be licensed, they must complete 12 hours of additional training beyond the 20 hours required under the Patient Protection and Affordable Care Act. The final rules for the state legislation were just posted this week.


Tom Alger, a spokesman for the Iowa Insurance Division, said the state plans to contract its portion of the training to a private company, and to his knowledge, the content of that training has not yet been developed.


"It's going to be a tight window, but it's possible to have them trained by open enrollment time," he said.


Bob Skow, president and CEO of the Independent Insurance Agents of Iowa, said the federal health care law prevents agents who sell health insurance from becoming navigators. However, licensed agents are in no way precluded from assisting people with using the online marketplace as well as shopping options outside of the online exchange, he said.


"There are tons of agents in every community who will be able to access the health insurance marketplace, so for every navigator there will probably be 100 agents out there who can help them through the maze," he said. "I think the navigators will hopefully be out there to provide some education, but I don't know how there would be enough to serve the whole population. I would think their target would be the underserved."


The Obama administration is encouraging volunteer efforts to get the word out.


"Navigators will be among the many resources available to help consumers understand their coverage options in the marketplace," Health and Human Services Secretary Kathleen Sebelius said in a release. "A network of volunteers on the ground in every state - health care providers, business leaders, faith leaders, community groups, advocates, and local elected officials - can help spread the word and encourage their neighbors to get enrolled."