They could have been worse, but they could still be better.
The Texas Department of Insurance on Tuesday issued state regulations for health care “navigators,” the workers who assist people seeking health insurance in the federal marketplace created by the Affordable Care Act.
The rules take into account some of the criticism aired recently by Democrats and health care advocates at public hearings, while also broadening the definition of “navigator” to allow additional organizations — not just those that received federal grants — to hire and train navigators.
“These rules will help ensure Texans have confidence that anyone registered as a navigator has passed appropriate background checks and received the training they need to safeguard a consumer’s most sensitive and personal information,” Texas Insurance Commissioner Julia Rathgeber said in a news release.
The rules require navigators to receive 20 hours of state-specific training in addition to the federal requirement of 20 to 30 hours of training, to undergo background checks, and to provide proof of identity. The rules also prohibit navigators from charging consumers, selling or negotiating health insurance coverage, recommending a specific health plan, or engaging in electioneering activities or otherwise supporting a candidate running for a political office.
Democrats and representatives from various health care organizations and nonprofits have raised concerns at public hearings held by the department that the proposed rules would impede navigators’ ability to educate people seeking health coverage, and divert time and funding away from their primary objective: helping people find health insurance.
In response to the public comments, the department removed from the proposed rules a $50 registration fee for each navigator. It also reduced the training requirements to 20 hours of state-specific training, from 40 hours in the proposed rules.
“There was no justification for the original proposal other than conservative politics,” state Rep. Lon Burnam, D-Fort Worth, said in a statement, “so I’m glad TDI has relented and come up with training requirements that are at least somewhat logical.”
Texans must apply before March 31 to receive federal tax credits to help pay for private coverage on the federal marketplace. Navigators must comply with the state’s additional training requirements and register by March 1.
Given the tight deadline, Democrats have alleged that the rules are politically motivated and are intended to curb enrollment in health plans offered in the federal marketplace. And despite the modifications, some Democrats and organizations that have hired and trained navigators say the rules will still increase costs, and take time away from navigators’ efforts.
Martha Blaine, executive director of the Community Council of Greater Dallas, which is among the groups that have received a federal grant to hire navigators, said the 12 navigators working for her organization have already undergone background checks and met other requirements in the state’s rules. She said she is unsure whether those efforts will have to be duplicated to meet the state’s requirements.
“It’s a bad use of resources, time and money,” she said.
See here, here, and here for the background. There’s a lot of people who’d like to enroll in an insurance plan via the exchange if Rick Perry and his cronies would quit interfering and get out of the way. Having these rules be only slightly obnoxious instead of blatantly obnoxious was probably the best outcome we could reasonably get. Here’s a side by side comparison of the rules as they were originally proposed and the rules that wound up being published (which you can see in full here), provided by Rep. Lon Burnam. I also received a letter Rep. Burnam sent about the original rules, and statements from Sen. Sylvia Garcia, and Reps. Garnet Coleman and Ruth Jones McClendon about the rules that were adopted. Finally, the Texas Organizing Project sent out a press release announcing a new collaborative effort to help inform folks about their health insurance options.