Saturday, August 31, 2013

White House: GOP Intimidating Obamacare Navigators

    On Friday, David Simas, the White House Deputy Senior Advisor for Communications & Strategy, raised the alarm: "House GOP targets hospitals, homeless shelters, food banks & senior centers educating people about ACA." In case that did not sound dire enough, he added the hashtag "#Intimidation."  Subtle it was not.  So what did those dastardly Republicans do?  Were there veiled threats of "That's a nice homeless shelter you've got there.  It'd be a shame if anything were to happen to it"?  Were they siccing the IRS on non-profits (at least the ones the IRS isn't already hounding)?  Not quite.
    In fact, the House Energy and Commerce Committee was simply exercising what is known as "oversight," or is known as oversight when the person using the term agrees with the action.  The action here is, according to Kaiser Health News, "asking recipients of the $67 million in health law navigator grants to brief the panel on how they intend to spend the money."  HHS announced the $67 million in grants on August 15, just two weeks ago.  Rep. Henry Waxman, the panel's ranking Democrat, had the hutzpah to say that:
the timing of the letters was "particularly suspect. You are insisting on voluminous document productions by Sept. 13, just when these groups need to be focused on their mission of helping uninsured Americans enroll for coverage." He added that the requests may have been sent "solely to divert the resources of small, local community groups just as they are needed to help with the new health care law."
    Rep. Waxman's complaint about timing is especially rich when you consider that Obamacare was passed in 2010, and yet navigators grants were announced a mere 45 days before the exchanges are due to open.  The GOP issued the informational requests within two weeks of learning the identities of these groups, has given them two weeks to respond, and will then have two weeks before Obamacare launches to process the responses and take appropriate action.  It is difficult to imagine what timing would have been acceptable to Rep. Waxman.
    The Republicans' concern is due to questions about security, screening, and training of navigators that will need to take place in a rather limited time.  Navigators will essentially be performing a service that for years professional brokers have provided, but with considerably less experience and education than brokers.  As Kaiser explains:
Navigators will provide assistance on the phone and in person to individuals signing up for coverage in the health law’s insurance marketplaces, as well as for public programs including Medicaid and the Children's Health Insurance Program. They will receive 20 hours of online training and have to pass a test before they can start working. Their efforts could include help in evaluating health plans for sale on the marketplaces, also known as exchanges. They are not, however, allowed to expressly tell people which policy to choose.
    The requirements are not exactly arduous.  Though the grant recipients have been screened by HHS, states "may choose to require minimum eligibility criteria and background checks" for the individuals tasked by the grant recipients to assist the public.  The most HHS has promised is to "take appropriate action if complaints of fraud and abuse arise."  With sensitive health information and private data, including social security numbers, potentially at risk, this reassurance is cold comfort.
    The 20-hour training of the navigators reminds me of an episode of the classic TV show from the 1960s-70s, Hogan's Heroes.  A recurring character, Col. Crittendon, a bumbling English officer, tells his fellow prison camp inmates who are planning a sabotage raid that he has commando training.  When they inquire about it, he tells them it was rigorous.  He didn't think he was going to make it, and it took every bit of grit and determination to soldier through.  He says it was worth every minute, but "I wouldn't want to go through a weekend like that again."
    Although a potential navigator might have to burn the midnight oil to get in 20 hours of online training in a weekend, it is certainly doable.  And more so since HHS cut the requirement from 30 hours just a few weeks before the $67 million in grants was announced.  Rather than intimidation, the GOP is performing due diligence to be sure future callers to the Obamacare help line aren't relying on modern day Col. Crittendons to help them get the most for their healthcare dollars.

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