The war between Texas Republican officials and the federal government, particularly over the Affordable Care Act, has escalated and poses a threat to thousands of Texans.
Caught in the middle of the political fight over healthcare is a venerable social service agency whose sole mission is to help people. The United Way of Tarrant County, a nonpartisan organization that has served our community for more than 90 years, does not deserve to become collateral damage in a partisan battle.
Texas was among the first states to opt out of the national healthcare program, defiantly refusing to expand Medicaid or set up a state insurance exchange under the law commonly known as Obamacare.
As the law requires, the federal government established a marketplace through which Texans could shop for insurance, with many of them qualifying for subsidies delivered through federal income tax breaks.
Even before the official Oct. 1 roll-out of HealthCare.gov, the federal online health insurance marketplace, Gov. Rick Perry objected to a U.S. Department of Health and Human Services plan to hire and train “navigators” to assist people in signing up for insurance.
Citing concerns about navigators’ qualifications, background and ethics, along with privacy issues, Perry asked the Texas Department of Insurance to come up with rules to regulate the outreach program.
Lt. Gov. David Dewhurst and Attorney General Greg Abbott, both running for office next year, also sounded alarms.
The federal government awarded almost $11 million in local Texas contracts, including $5.9 million to United Way of Tarrant County, to hire more than 75 navigators across the state. Although those hired by United Way received more than the 20 hours of training recommended by HHS and underwent required background checks, that apparently wasn’t enough for Texas officials.
The state insurance department proposed rules this past week that would require 40 additional hours of training, with testing, as well as a higher level of background checks. The proposed rules also call for “evidence of financial responsibility,” and include a list of prohibited activities that are already forbidden at United Way.
A public hearing on the proposed new rules has been set for Dec. 20 in Austin. The insurance department will accept public comment through Jan. 6, 2014.
United Way President Tim McKinney said the organization will comply with all regulations the state puts in place. But he said new rules will add costs to the program.
For example, the insurance department’s proposal says fingerprints for background checks “must be captured by a law enforcement agency” (like the Department of Public Safety). The estimated cost for that is between $41.45 and $62.45 for each navigator. In addition, the agency and each navigator must register with the state, which carries a $50 fee.
The required “evidence of financial responsibility” means that entities hiring navigators must purchase a surety bond, obtain a professional liability policy of at least $100,000 or deposit with the state comptroller $25,000 in securities backed by the full faith and credit of the United States.
And perhaps most costly, every hour that navigators spend in extra classes is time that could have been spent working for Texans who need help.
There are more than 6 million uninsured Texans, including 415,000 in Tarrant County. The proposed additional state rules look like more of a hindrance than a help in addressing this need.
“This is an attempt to add cumbersome requirements to the navigator program and deter groups from working to enroll Americans in coverage in the Health Insurance Marketplace,” said HHS press secretary Fabien Levy. “The navigator program is similar to Medicare counselors, which have existed for years and never faced this kind of scrutiny from Texas.”
United Way and other groups should not be deterred in getting more Texans signed up for healthcare.
United Way’s McKinney says his agency will meet all state requirements. Another way to put it is that they’ll overcome all obstacles.