By John Reichard, CQ HealthBeat Editor
September 26, 2013 -- Thirteen states with almost half of the nation's uninsured population have passed laws or regulations blocking health care law navigators from helping to guide those without coverage through the enrollment process, the left-leaning organization Health Care for America Now said in a study released last week.
Some of the state laws involved are unprecedented in that they "go after community-based groups that are working to provide consumer assistance," Georgetown University research professor Sabrina Corlette said during a telephone press briefing on the report.
"Which isn't to say that there aren't legitimate concerns about fraud or con artists taking advantage of Obamacare," she added. "It's just that these state laws are barking up the wrong tree. There's just no credible evidence whatsoever that navigators will be a source of fraud. In fact, just the opposite."
The states include 17 million uninsured people, or 41 percent of the uninsured population eligible for expanded coverage under the health care law (PL 111-148, PL 111-152), according to the report. The 13 states are Arkansas, Florida, Georgia, Iowa, Illinois, Indiana, Maine, Missouri, Montana, Ohio, Tennessee, Texas and Wisconsin.
"These excessive requirements include such things as residency rules, fingerprinting, extra fees, superfluous certification exams and background checks, even though previous experience with Medicare counselors suggests that no such protections are needed," the report said.
It said that in Texas, for example, navigators must have 40 hours of state training in addition to the 20 hours the health care law requires. Republican Gov. Rick Perry "is even trying to limit the hours of navigator operations from 8 a.m. to 5 p.m., which is an extraordinary restriction for ordinary folks who are working for a living who want to buy insurance and get benefits," said an HCAN official.
In Georgia, navigators must pass an exam that is required for insurance agents even though navigators are not permitted to provide the same level of assistance to the uninsured as brokers are, the report said.
House Energy and Commerce Committee Republicans say criminal background checks are needed for navigators to protect against identity theft. They say that practices such as door-to-door visits to enroll the uninsured could make people vulnerable to fraudsters posing as navigators, among other concerns. A federal official told a congressional panel last week that navigators would not be going door-to-door to counsel consumers.
"In the case of the navigators, these groups have already been vetted through the grant-making process," Corlette said. "They've had to meet tough federal standards for training, conflict of interest. So these state laws are not only unnecessary, but they are clearly designed not protect consumers but to undermine implementation of the Affordable Care Act."
HCAN Executive Director Ethan Rome said that "some of the Obamacare opponents may think they're attacking the president or the law, but mostly they're hurting real people with real health care needs. This isn't just an abstract political debate. For people without health insurance, this is about whether they can get medical care and whether they can get it without going bankrupt."
- Report (PDF)