The administration had initially planned to spend less — $54 million — on navigators in the 34 states where the federal government will run all or part of new insurance markets created under the law. Chiquita Brooks-LaSure, an official with the Department of Health and Human Services, said the additional $13 million had come from a fund set up under the health law to pay for public health and preventive care initiatives.
The administration has transferred several hundred million dollars from the fund to pay for aspects of the law, drawing criticism from some members of Congress.
Kathleen Sebelius, the secretary of health and human services, has said that she had no choice but to tap the prevention fund because Congress refused to provide money for outreach and education activities. The fund, originally $15 billion over 10 years, is supposed to support wellness and disease-prevention programs around the country.
Senator Tom Harkin, an Iowa Democrat who has championed the fund, said in May that it was “ill advised and shortsighted to raid the prevention fund, which is making absolutely critical investments in preventing disease, saving lives, and keeping women and their families healthy.”
The stakes are high for the navigator effort, because for the law to succeed, millions of people, particularly the young and healthy, need to buy insurance through the new markets. Many will qualify for federal subsidies to help with the cost. But there will be wide discrepancies from state to state in spending on navigators, and in how many people they can reach.
States building their own insurance markets will generally spend much more on the effort than states that ceded the job to the federal government.
The 105 groups that were awarded navigator grants on Thursday include universities, health clinics, hospital systems, church groups and health advocacy groups. The grants range from $20,750 for Catholic Social Services, a group in Mobile, Ala., to $5,889,181 for United Way of Tarrant County, which serves the Fort Worth region in Texas but will help with enrollment around the state.
Eight groups in Texas received a total of about $10.9 million, more than any other state. Texas has one of the largest uninsured populations in the country, about 27 percent of its residents, or six million people.
In Mississippi, Oak Hill Missionary Baptist Church Ministries will dispatch clergy members as navigators in the state’s Delta region. And in Maine, Fishing Partnership Health Plan, which provides subsidized coverage to commercial fishermen, will work with the Maine Lobstermen’s Association to get the word out about the new insurance market.
The groups will spend the coming weeks hiring and training navigators who will then fan out across the 34 states, spreading the word about the new insurance markets and, starting Oct. 1, helping the uninsured shop and sign up for coverage. Navigators will be required to get at least 20 hours of training, then pass a certification test.
“Navigators will be among the many resources available to help consumers understand their coverage options in the marketplace,” Ms. Sebelius said. “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.”