Community Health Workers as Health Insurance Marketplace Navigators: Lessons Learned and Paths Forward

This presentation highlights the successes and challenges of utilizing Community Health Workers as Health Insurance Marketplace Navigators in the Lower Rio Grande Valley (RGV), Texas.  For residents of the Valley, where they live greatly affects their health and well-being. The Rio Grande Valley is located in the southernmost tip of Texas along the U.S.-Mexico border and includes Cameron, Hidalgo, Staff and Willacy Counties.  In this Region, the majority (91%) of residents are Hispanic or Latino.  These counties rank among the worst in Texas in terms of behavioral, social, and environmental factors that affect health.  Additionally, there is a large uninsured population.  We estimate that there were 353,671 uninsured persons in the Valley in 2011.  Approximately, 219,057 of these uninsured individuals had family incomes at or below 138% federal poverty level (FPL), and approximately 116,746 had family incomes above 138% FPL, but no higher than 400%. 

MHP, Inc. was awarded a Federal Navigator Grant in 2013 to provide direct enrollment services and educational outreach about the Affordable Care Act to uninsured people in the RGV.  Promotores(as) de Salud were a natural fit for the job but barriers in training and certification, such as the English only, on-line modules caused unforeseen complications and delays.  The utilization of Promotores(as) de Salud is ideal for engaging difficult to reach populations such as the Valley’s uninsured.  For these programs to be successful however, there is a need for supplemental training and education activities based in popular education offered in Languages accessible to that population.