Asssessing the role, function and challenges of ACA Navigator in enrolling violently injured young Black men into health insurance coverage

Lack of insurance coverage prohibits many victims of violent injury (particularly low-income young Black men) from receiving continued care, and their injuries cost the healthcare system billions of dollars per year. The Affordable Care Act (ACA) has established Navigators to educate and enroll hard to reach populations into the new healthcare insurance coverage system. An important aspect of the ACA is its emphasis on hard to reach vulnerable populations of young adults (i.e., low-income young Black men). Low literacy levels, lack of access to broadband, and limited English proficiency will all limit the ability of hard to reach vulnerable populations to independently enroll through the Health Exchange and will increase the need for Navigator services. Navigators can provide information that is culturally and linguistically appropriate to meet the needs of vulnerable populations being served by the Exchanges.  However, little is known about the challenges, obstacles and best strategies used by the ACA Navigator to enroll hard to reach vulnerable populations of low-income young Black male victims of violent injury/trauma into healthcare insurance. Drawing on in-depth interviews and observations, this paper qualitatively assesses the role and function of the ACA Navigator, specifically their challenges, strategies and experiences with enrolling young Black male victims of violent injury into health insurance coverage. This paper qualitatively identifies how Navigators improve vulnerable, hard to reach populations of young Black men access to health insurance coverage information. This study was conducted at Prince George’s Hospital Trauma Center the busiest Level II trauma unit in the US.