Now that open for enrollment has begun, consumers will likely have many questions about the health insurance exchanges, including how to enroll, what information is needed to apply for policies and whether they qualify for subsidies. That's why the reform law created navigators, a group of people who help consumers understand how to shop for health plans through the online marketplaces.
The problem, however, is 13 states--Arkansas, Florida, Georgia, Iowa, Illinois, Indiana, Maine, Missouri, Montana, Ohio, Tennessee, Texas and Wisconsin--have passed laws or regulations that prevent these navigators from guiding consumers in exchange-related matters, according to a report from Health Care for America Now.
Some of the states claim navigators' outreach activities could be a potential source of fraud. Consequently, some state laws require navigators undergo strict residency rules, fingerprinting, extra fees, additional certification exams and background checks, the report found.
But industry experts worry these laws actually undermine the enrollment process--and could prevent insurers from adding new members. "There's just no credible evidence whatsoever that navigators will be a source of fraud," Sabrina Corlette, a Georgetown University research professor, said during a press briefing on the report, according to CQ HealthBeat. "In fact, just the opposite."
"In the case of the navigators, these groups have already been vetted through the grant-making process," Corlette added. "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."
To learn more:
- here's the Health Care for America Now report (.pdf)
- read the CQ HealthBeat article