Under the auspices of protecting patient information, Pennsylvania lawmakers have once again introduced legislation designed as an impediment to signing up for health insurance under the Affordable Care Act.
Passage of this legislation would make Pennsylvania the latest state to regulate a program that helps people navigate the sometimes complicated ACA online marketplace.
The Obama administration created a consumer assistance program as part of the effort to encourage Americans to sign up for health insurance. Called navigators or assisters, tens of thousands of certified people across the United States help consumers understand their health coverage options, apply for insurance, and enroll.
Assisters have proven essential amid a process marred by confusion and technological glitches. During the 2013-2014 open enrollment period, an estimated 10.6 million people had the aid of assisters while applying.
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All state marketplaces are required to have assister programs under the ACA. But Republican lawmakers in many states have pushed back on the programs, calling for legislation that makes it more difficult for people to become assisters.
As of January 2014, at least 17 states had passed some form of regulations on health-care navigators as Republican policymakers look to undermine the health-care reform law.
Pennsylvania’s SB 293 would add to that list. The bill, introduced last week by state Sen. John Eichelberger (R-Blair County), would require assisters to undergo specific certification by the state. Because Pennsylvania opted out of creating its own insurance marketplace, consumers use Healthcare.gov, the marketplace created by the federal government, which already has certification rules for assisters.
The requirements outlined by SB 293 would be tacked on to federal rules that include a 20-hour training and certification by the Centers for Medicare and Medicaid Services.
The bill appears to be a watered-down version of SB 1268, a measure that failed last year in Pennsylvania. Unlike last year’s bill, the current proposal would not make it a conflict of interest for an entity providing health-care services to serve as a navigator—a provision that would have shut down navigator services at the lead organization in the state, the Pennsylvania Association of Community Health Centers.
The current proposal has many provisions in common with its predecessor, including a gag order that would prohibit navigators from discussing “health benefit plans or other products other than those offered in the health insurance marketplace.”
In other words, navigators would not be allowed to talk about Medicaid or the Children’s Health Insurance Program (CHIP) to consumers whose incomes qualify them for public insurance.
Advocates of navigator restrictions say that the laws are necessary to protect consumers from fraud and misinformation, which advocates of the restrictions claim to be rampant.
But experts contend that the restrictions are part of a larger effort on the part of Republicans to make the ACA look bad, and are a double standard when compared with the uncontroversial Medicare assisters program.
“The navigator program is similar to Medicare counselors, which have existed for years and never faces this kind of criticism from Congress,” Brian Cook, an HHS spokesperson, told the Wall Street Journal. “The shameful and unprecedented attempt by some in Congress to bully and intimidate these private organizations is clearly an ideologically driven attempt to prevent uninsured Americans from gaining health coverage.”
“I think the privacy concern is more of a political issue than a common sense one,” Peter Shin, a professor of health law and policy at George Washington University, told Mother Jones. “The more disenfranchised communities will be hurt the most from navigator restrictions.”
Evidence confirms that Republican politicking comes at the expense of communities who need help the most.
States that have implemented restrictions on navigators have navigators who are less likely to help people gather required documents, fill out paper enrollment forms, and have assistance in languages besides English, according to a 2014 study.
(Nina Liss-Schultz, the writer of this report, volunteers as an assister at a medical clinic in her community.)