Health & Science

State On Verge Of Imposing Tight Regulations On Obamacare ‘Navigators’

Now that it's 2014, almost all elements of the Affordable Care Act are fully in place. But that doesn't mean the wrangling over the law has stopped. In Texas, the state insurance department is preparing new regulations to more tightly control the people who help residents sign up for insurance.

You may have never heard of healthcare navigators, and you may never meet one. But these foot soldiers of the Affordable Care Act have been on the job for months, working the phones and holding sign-up events to help uninsured Texans.

Now the community groups that employ these navigators are bracing for new state regulations.

The proposed rules would require that navigators undergo 40 more hours of training, on top of the 20-30 hours they’ve already done.

The navigators would also have to register, be fingerprinted and undergo background checks.

Lucy Nashed is a spokeswoman for Gov. Rick Perry, who urged the insurance department to craft the regulations last fall.

“People who are working with these navigators in Texas should have the reasonable expectation that they are well trained, that they are not criminals, and that they are not going to use that private information for anything illegal.”

The city of Houston employs dozens of navigators, some of them paid for with grants from the Affordable Care Act.

City health official Benjamin Hernandez says it looks like the new rules could go into effect in March, and the timing couldn’t be worse.

That’s because March 31 is the last day people can sign up for coverage for 2014 and avoid a tax penalty.  

“March is important because it’s the last month of the enrollment period and what we want are our navigators out there talking to people, we don’t want them sitting in a classroom for 40 hours.”

Hernandez and others wonder if navigators are being unfairly targeted.

By contrast, Texas requires Medicare counselors to undergo only 25 hours of training.

Medicaid counselors do only four hours of training in Texas.

And both those trainings are free, while the proposed navigator training and registration will cost hundreds of dollars per person.

“That really doesn’t make sense why you’re asking one group to do a whole lot more training.”

Stacey Pogue is with an Austin think tank, the left-leaning Center for Public Policy Priorities.

She says the proposed rules even try to control what navigators can and can’t say about the various health plans.

She says that could make it very hard for them to do their jobs, which is simply to help people understand how insurance works and help them enroll.

“What we try to do is empower those navigators, we try to empower community groups to go out and help sign people up for benefits. And this seems like an unprecedented move — from what we can tell — in the other direction, where the state is actually for the first time trying to create big barriers that prevent community groups from providing application assistance to poor and underserved Texans.”

The Texas Department of Insurance has closed the public comment period and is expected to issue the final rules in a few weeks.

Nationwide, at least sixteen states have passed or are considering laws to regulate navigators.

Two of them, Missouri and Tennessee, have been sued over the laws.