Obamacare Woes Mount as States Target 'Navigators'

Tuesday, 16 Jul 2013 01:51 PM

By Andrea Billups

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The obstacles to implementing Obamacare appear to be growing as more states consider legislation that would place tough restrictions on "navigators" who help direct consumers to the best coverage plan for their needs.

Some state legislatures have passed, or are considering, laws that would make these navigators undergo criminal background checks, training, and licensing. Some bills would also force them to carry liability insurance, The Hill reports.

The "navigator" provision in the Affordable Care Act was designed to create Obamacare experts to help advise and guide consumers in choosing the right coverage plan for their needs.

Related: Key Obamacare Mandate Delayed: Repeal Plea Renewed

The move by the states will make it harder for the administration to get people to sign up for the healthcare exchanges, which will be implemented by Jan 1.

And the action comes as key parts of the Obamacare law already have been delayed by the administration.

Earlier this month, the Department of Health and Human Services delayed for one year the employer mandate, which forced businesses with 50 or more workers to provide health insurance or pay a fine. HHS also delayed for a year the requirement that people seeking Obamacare subsidies will need to prove their income levels.

Under Obamacare, states are allowed to devise their own specific requirements for navigators as long as they don't compromise rules under the federal plan.

Related: Realities Force President to Scale Back Vision for Obamacare

While most acknowledge the importance of having helpers for underserved consumers who may not understand insurance coverage, some fear the possibility of fraud if the navigators do not have proper training or oversight.

"The state laws are a positive development," Ryan Young, a senior director of government affairs at the Independent Insurance Agents and Brokers of America, told The Hill.

His association is working with state lawmakers as they move to implement the law, and he says navigators should have professional liability insurance of their own in case mistakes on behalf of consumers are made.

"What we have is a federal program authorizing individuals and entities with no healthcare background to go out and advise folks on health insurance," he said. "We just want to make sure they’re properly licensed, trained and overseen."

Related: Obamacare Rule to Verify Income Levels Is Scrapped

The administration is trying to fight back at the increasing efforts to hinder or derail various provisions of the healthcare reform initiative by reminding Americans that many Republican-led states are trying to deny them coverage they have a right to under the federal law.

The Department of Health and Human Services plans to provide notes to poor consumers when they begin applying to enroll in health insurance exchanges, informing them their own state may be among some 20 Republican-controlled states that are denying them coverage by refusing to participate in the Medicaid expansion portion of the law, The Huffington Post reports.

Currently more than 20 states have refused to expand their Medicaid programs, a move that basically denies federal funding that would fully pay for adding new patients to the program rolls through at least 2016.

In addition, 34 states have refused to create their own healthcare insurance exchanges to provide a more competitive marketplace for consumers to choose plans, leaving it up to the federal government to establish and run them. Sixteen states and the District of Columbia are creating their own exchanges and will be in charge of them.



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