The roll-out of the Affordable Care Act in October got off to a rocky start with the colossal failure of the system’s website, HealthCare.gov.
Blame for that blunder falls squarely on the Obama administration.
But outside forces made up mostly of Republican elected officials, including Texas Gov. Rick Perry, have thrown up roadblocks from the beginning with a misinformation campaign, refusal to create state insurance exchanges and, more recently, deliberately hampering a federally funded program to help people sign up for insurance under the ACA.
Through a federal grant of almost $11 million, Texas agencies like United Way of Tarrant County were contracted to hire and train “navigators” to assist uninsured Texans with understanding and applying for insurance coverage.
Those navigators hired by United Way received more than the 20 hours of training required by the Department of Health and Human Services and underwent background checks. But that was not good enough for the governor.
Under the guise of protecting Texans’ privacy, Perry asked the Texas Department of Insurance to come up with new rules to govern the navigators, which it did.
Among other things, TDI proposed an additional 40 hours of training (with testing), more background checks and “evidence of financial responsibility” (or bonding). The proposals add significantly more costs to the program for individual navigators and the agencies that hire them.
At a hearing on the department’s recommendations Dec. 20, United Way President and CEO Tim McKinney said the 16 organizations responsible for hiring the 158 navigators all “have long and successful histories of serving Texans in need, and all are financially stable and sound, which should negate the requirement to secure and maintain evidence of financial responsibility as proposed.”
He’s right. Participating are two United Ways, two councils of governments and 12 community-based organizations, including the city of Houston and the Community Council of Greater Dallas.
McKinney also testified that many of the navigators have backgrounds as benefit counselors for the Health Insurance Consumer Advocacy Program (HICAP), which is regulated by the TDI. In addition, he pointed out that the state is requesting far more registration requirements for ACA navigators than the TDI requires for HICAP and Community Partners workers who basically are doing the same thing.
Again, he’s right. Those two state programs, which help inform older Texans and those with disabilities about health care coverage and public benefits, have been operating for years with little or no complaints.
Ironically, the HICAP staff and volunteers are in 28 Area Agency on Aging offices. In Tarrant County, the local Area Agency on Aging is under the United Way, the lead organization in Texas providing training for navigators.
Those HICAP staff members and volunteers, according to the TDI website, “are trained in all aspects of public and private benefits,” including Medicare and Medicaid eligibility, Medicare supplement insurance policy benefits and the pros and cons of Health Maintenance Organizations. And they do all that with fewer training hours than the state is requiring for navigators.
The costly, time-consuming requirements will only add to difficulties of getting more people signed up for health insurance. And they are enacted, navigators must comply by March 1, almost assuring more problems at the beginning of the last month for ACA open enrollment.
McKinney asked the department not to impose the “extreme and unnecessary” regulations, as they “will have a negative impact on those consumers who we are trying to serve.”
As Rep. Chris Turner, D-Grand Prairie, pointed out, the new rules are not aimed at protecting consumers. “Rather they seem clearly intended to make a political statement.”
The TDI will accept public comment on the proposals through Jan. 6, when it will hold a final hearing.
The whole idea should be abandoned, and the governor and TDI should not encumber these well-trained navigators from continuing to sign up Texans for health insurance.