By TONY PUGH
McClatchy Washington Bureau
The individuals and groups tasked with helping people enroll for health insurance coverage under the Affordable Care Act are facing a stiff head wind of restrictive laws, regulations and outright obstruction in some Republican-led states.
In Florida, health officials won’t allow these so-called “navigators” onto county health department properties to help uninsured people sign up for coverage in the new state insurance marketplaces.
In Georgia, state Insurance Commissioner Ralph Hudgens recently told a gathering of Republican
supporters that the state would do “everything in our power to be an obstructionist” of the Affordable Care Act.
Navigators also have drawn the ire of congressional Republicans, who’ve asked 51 navigator groups nationwide for detailed
information about their
activities, funding and staffing just as the groups are training and preparing for the launch Oct. 1 of the marketplace open-enrollment period.
In a recent hearing on the health law, Rep. Frank Pallone, D-N.J., called the Republican requests
“This is an egregious abuse of the committee process and an attempt to intimidate community
organizations and overwhelm them with information requests at a crucial
period so that they don’t
implement the program,” Pallone said.
Rep. Michael Burgess,
R-Texas, was unapologetic, however.
“Why wouldn’t we have questions about the vast sums of money that have been pushed out the door relatively hastily to these navigator groups,” Burgess said. “Why wouldn’t we have questions as to their credentials ... their ability to provide what they’ve been required to provide?”
The Obama administration responded to the Republicans on behalf of the navigator groups, but the political scrutiny and heightened legislative oversight have taken a toll. Several navigator organizations around the country have returned their ACA funding and dropped out of the program because of complications involving state laws.
Trained to be impartial consumer-outreach workers
who are prohibited from
recommending one health plan over another, navigators are crucial to meeting the Obama administration’s goal of enrolling 7 million
Americans in health cover-age through the market-places next year.
But that undertaking has been complicated by the navigators’ late start, their limited funding and widespread public confusion about Obamacare. Tough state laws regulating the navigators have added to the challenge.
In Ohio, Missouri, and Georgia, navigators can’t give advice about the
benefits, terms and conditions of marketplace health plans. Consumer advocates say those laws conflict with federal guidelines that call for the navigators to help people compare and understand the differences among health plans offered in the marketplaces.
For that reason, the Center for Health Law Studies at Saint Louis University has asked Missouri not to
enforce its provision.
Navigators in Louisiana, Missouri and New Mexico can’t assist people whose current coverage was purchased from an insurance agent or broker, which
greatly limits the universe of people they can help.
State law requires
Nebraska navigators to
inform people who already have insurance that they can seek similar assistance from insurance agents and brokers.
In Georgia, navigators can’t initiate contact with anyone who currently has insurance. A similar law is pending in Pennsylvania.
“They’re basically telling them who they can and can’t talk to,” said Mark Dorley, a health policy researcher at George Washington University, who studies navigator laws.
At least 16 states have passed laws requiring
licensing or certification of navigators beyond the
federal requirements, and five have similar laws pending, Dorley said.
Republican officials say the state certification laws protect the public from
navigators who could be poorly trained, have criminal backgrounds and
possibly misuse or reveal consumers’ personal health information.
Texas Attorney General Greg Abbott was among
13 Republican attorneys general who called for
stricter state regulation of navigators.
In Atlanta, Bill Rencher, a navigator in training, said the politically charged
atmosphere had everyone’s attention.
“I’m a little concerned,” said Rencher, the health-access program director at Georgia Watch, a statewide consumer-advocacy group. “I think there’s definitely going to be some very active oversight going on that we all need to be aware of.”
We definitely have a lot of work ahead of us, and the partisanship around this is not making it any easier.”