WASHINGTON – 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 “despicable.”
“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.
“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 Affordable Care Act 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 coverage through the marketplaces 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 Missouri, Georgia and Ohio, 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.
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.
Obamacare supporters argue that navigators will provide the same type of assistance as workers who help enroll seniors in the Medicare program.
Insurance agents and brokers, who view the navigators as competition because they provide similar services, have lobbied states to enact tougher oversight laws for navigators.