By Ryan Ekvall | Wisconsin Reporter
MADISON — Federal health bureaucrats know applying for health insurance through the federal health care exchanges won’t be easy.
If it were, there wouldn’t be the need for tens of thousands of taxpaye- backed “navigators,” new positions that soon will be created to help steer consumers through the rough waters of Obamacare.
The U.S. Department of Health and Human Services will provide Wisconsin with $829,300 in navigator grant funds as part of the $54 million HHS set aside nationally for one year’s worth of navigators. There is $1.7 million more available for community health centers through HHS.
Republicans on the state Legislature’s Joint Finance Committee want to make sure that not just any schlub who passes 30 hours of HHS-administered training, and navigates through the host of other regulations set by the federal government in its 63 pages of rules, gets to be an Affordable Care Act navigator.
“Basically what you’re looking at (with the JFC regulations) is a focus on Wisconsin-based issues, which the federal regulations for the exchange is not going to do,”J.P. Wieske, spokesman at the state Office of the Commissioner of Insurance, said in a telephone interview. “You’ve got a consumer coming in and they’re vulnerable. We need to make sure (the navigators) know what they’re talking about and are acting appropriately.”
State oversight would include an additional 16 hours of pre-licensing training and completion of a written examination that passes muster with the Office of the Commissioner of Insurance. The commissioner also can set testing requirements and fees for the tests, if the JFC’s motion passes through the House and Senate and survives the governor’s pen.
In addition to testing fees, the JFC set the initial license fee for a navigator at $75, with an annual license renewal of $35, which can be changed by the commissioner. The fees are $100 for entities that hire navigators.
Navigators, or their sponsoring entities, also will have to furnish a bond of at least $100,000 to protect “against the wrongful acts, misrepresentations, errors, omissions, or negligence of the navigator.”
These Obamacare Sherpas will, after all, have access to Social Security numbers, a host of patient financial and medical information and other sensitive data.
But some in the nonprofit community say the regulations are excessive and not about protecting consumers.
“It’s people trying to protect their turfs,” said Bobby Peterson, executive director of ABC for Health, a Madison-based nonprofit public interest law firm that links families to health care benefits. “A lot of brokers are alarmed. Their association is alarmed. A lot of what health care navigators will be doing is outside the scope of what an agent or a broker would be doing. It’s a bit of a tempest in a teapot.”
After the motion passed, two health insurance associations put out news releases championing the finance committee’s decision to protect consumers. The American Cancer Society put out a release blasting the “potentially onerous regulations.”
Peterson said navigators will be doing a lot more than comparing health care plans in Wisconsin. For example, he said, the removal of a projected 87,000 adults on BadgerCare who will become eligible for insurance on the federal exchange under Gov. Scott Walker’s Medicaid proposal adds to the already confusing seascape of the new federal health law.
“Those are issues that brokers are not going to want to deal with. So it’s a little ridiculous at some level,” he said.
Misha Lee, a lobbyist at the Independent Insurance Agents of Wisconsin, acknowledged that some level of protectionism is built into the proposed regulations.
“There is a factor in terms of trying to have somewhat of a level playing field,” he said. “Agents already today have to go through a number of different hurdles, but from our perspective, primarily this is about protecting consumers.”
Matt Banaszynski, executive vice president of the Independent Insurance Agents of Wisconsin, said in a statement that the regulations “will also help preserve the role of the health insurance agent and the viability of the health insurance market in Wisconsin.”
Health insurance agents, or any insurance agent who receives compensation from a health insurance company, will not be allowed to become navigators under the federal rules. However, other insurance agents such as property and casualty agents will be eligible to become navigators and receive federal grants.
Lee said health insurers are “feeling their livelihoods targeted because of the Affordable Care Act.”
“I think we sympathize with (critics) and understand their concern that dealing with a whole new health care delivery system is a challenge,” he said. “I think saying that (the regulations) are a barrier for people to gain access to the exchanges or to become navigators is misguided. From our perspective, the barrier is the whole new world order of the Affordable Care Act.”
Contact Ryan Ekvall at [email protected]