How “Deadliest Catch” Helps Explain the Affordable Care Act’s Navigator Program

By William Tomasko

If you’re like me, you’ve probably never hung up a poster in a local fishing bait shop to advertise health insurance, and you might be surprised to learn how the story of one community coming together to do so illuminates a major feature of implementing the Affordable Care Act.

Consumers will need help sorting through their new options for quality coverage in the fall, so states and the federal government are gearing up to award grants to community-based organizations that can serve as navigators to the process. By looking to Massachusetts, we can already see vivid evidence of just how effective that kind of personalized attention can be.

In the 1990s, the region’s commercial fishermen launched a new, shared risk pool to make affordable health coverage available, and they innovated an early model of the ACA’s navigator program to boost enrollment (you can read the full story on page 23 of a report from the Center for American Progress). Since fishing is such a dangerous job (they call the TV show “Deadliest Catch” for a reason), those workers had been having a hard time finding affordable coverage. But to make the new affordable option successful, the Fishing Partnership needed to enroll thousands of hard-to-reach fishermen, many of whom spoke different languages and all of whom were “literally at sea during their workday.”

To overcome those logistical hurdles, they established a new “navigator” program. The navigators “needed to understand the nuances of the fishing industry,” so “fishermen’s wives and daughters proved to be the most successful navigators.” The family members could speak the right languages. They knew the most popular bait houses in which to hang up posters. They knew when the workers would be back on shore and available to sign up.

Thanks to the successful navigators, the rate of uninsured fishermen in Massachusetts plummeted from 43 to 13 percent, and the state could use the community’s assistance strategies as a model for statewide outreach once the state launched its own health care reform. To this day, the Fishing Partnership’s program is still connecting fishermen to trained navigators who understand the kinds of challenges they face because the navigators come from fishing families themselves.” Below are two videos of navigators with the Fishing Partnership.

Angela Sanfilippo on the heritage of Navigators

Verna Kendall on health insurance

The navigators turned the promise of affordable care into a reality. Their localized knowledge boosted enrollment, and similarly targeted outreach in communities across the country can do the same for the new health insurance marketplaces. And luckily for today’s navigators, not all of the new consumers will be on boats all day.


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