title: The Voyage of a Navigator An aspiring scholar's inside observations on the Affordable Care Act's rocky roll-out in North Carolina.
abstract: North Carolina, a federally facilitated marketplace under the Affordable Care Act (ACA), stumbled in 2013 when opening its health-insurance exchange. Trouble was easy to foresee, as North Carolina had instituted a law barring any state agency from assisting enrollment in health-insurance plans made available through the ACA. Trained workers were needed to help citizens and legal immigrants "navigate" to these plans. Some of these "navigators" could be paid with federal funds, but many others had to work as volunteers. I was one of these volunteer navigators. Much went wrong in training, staffing, and operations, but much still was accomplished. Here I report observations, share assessments, and offer suggestions for similarly complex situations.
authors.affiliation: University of North Carolina-Charlotte.
authors.forename: Hollie L
authors.initials: HL
authors.lastname: Tripp
mesh_terms: D054242:Emigrants and Immigrants; D062265:Health Insurance Exchanges / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D009657:North Carolina; D062526:Patient Navigation / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act / Q000458:organization & administration*
keywords: Affordable Care Act (ACA); choice theory; consumer enrollment; health insurance marketplace; health literacy; health reform; navigator