Counselors who help Texas residents sign up for health insurance under the Affordable Care Act criticized proposed state rules Monday that would require them to undergo more training and pay fees, saying the regulations would impede people from getting healthcare.
Texas Insurance Commissioner Julia Rathgeber held a public hearing on the rules her agency generated after Gov. Rick Perry called for stringent regulation of so-called navigators, whose job is to help people sign up for health insurance using new healthcare exchanges. Perry and other Republican leaders say the rules are needed to protect consumers from fraud and bad advice.
But state Sen. Kirk Watson, D-Austin, who wrote the law allowing the commissioner to draft rules, told Rathgeber, a Perry appointee, that the proposed regulations go too far. He specifically cited requirements that the navigators have 40 hours of training – in addition to the federally required 20-30 hours, get liability insurance and pay fees for fingerprints, tests and classes.
“That kind of training requires real time and costs real money. Where did the additional 40-hour requirement come from exactly? Who is it truly meant to help?” Watson asked. “TDI has failed to provide any explanation although repeatedly requested to do.”
In public comments submitted to the state, state Rep. Lon Burnam, D-Fort Worth, said he had obtained documents from the Texas Department of Insurance indicating that the department chose a 40-hour requirement because of political influence. The department has said the documents are confidential under attorney-client privilege, said Burnam’s staff, and wouldn’t allow him to release them to the public.
“The lack of any rational basis for the determination of the hour requirements, combined with the apparent political influence from officials who have publicly dedicated themselves to obstruct the implementation of the Affordable Care Act, makes these training requirements the very definition of arbitrary,” Burnam said in his comments.
The department estimates that meeting the requirements to be a health insurance navigator would cost more than $800 a year. But navigators are prohibited by federal law from charging for their assistance to recoup those costs.
Witnesses complained that the high fees and lengthy training are not required for healthcare navigators who help people sign up for Medicare, the federal health insurance program for the elderly, or Medicaid, the healthcare program for the disabled and poor. Democratic lawmakers said Perry and his appointees were trying to hinder people from using the federal healthcare exchange.
Martha Spinks, director of the Bexar Area Agency on Aging, said the proposed rules would create unnecessary obstacles to insuring people in a state that has the nation’s highest percentage of uninsured. She said all other health counselor training is free and questioned why Affordable Care Act navigator training should cost $800 and take so long.
“I am skeptical that there is sufficient content for an additional 40 hours of training,” she said, explaining that her agency already trains navigators for 30 hours.
Only one witness testified in support of the proposed regulations, Republican state Rep. Paul Workman. He said the federal training requirements were insufficient.
“To expect a noninsurance person to get up to speed on health insurance, not to mention the ACA, cannot be accomplished in 20-30 hours,” he said. “The rules are not overly burdensome or overreaching.”
Threat to Texans
Later, Republican Lt. Gov. David Dewhurst proclaimed his support for the regulations.
“In addition to the threat Obamacare poses to state and family budgets, the currently unregulated, unscreened cadre of navigators descending on Texas could pose a threat to our citizens’ personal safety,” he said in a statement.
Rathgeber did not respond to questions and said she would consider the testimony given Monday in making her final decision.
Critics asked that even if she decides to impose the regulations, she should delay their implementation until after the open enrollment period ends March 31. Watson complained that publishing the rules in February and requiring compliance by March 1 would not give navigators time to complete the training in time for what is expected to be the busiest month for people signing up for health insurance by the federal deadline.