published Friday, September 13th, 2013

Tennessee imposes new rules ahead of health law

WHAT ARE NAVIGATORS?

Navigators are individuals or organizations trained to help consumers, small businesses and their employees as they look for health coverage options through the Marketplace. Navigators will also help people complete eligibility and enrollment forms.

Navigators will not function like insurance brokers, and they are required to be unbiased. Their services are free to consumers, and they are paid through federal grants.

In Tennessee, the organizations that have been awarded navigator grants to do community outreach efforts are the Tennessee Primary Care Association and Seedco.

WHAT IS THE HEALTH INSURANCE MARKETPLACE?

The online Health Insurance Marketplaces are meant to be a one-stop shop for people to buy private plans that meet federal stipulations and are tax-subsidized.

Source and more information at: HealthCare.gov

New Health Care Navigator Rules
New Health Care Navigator Rules

In just a few weeks, hundreds of thousands of uninsured Tennesseans will be eligible to sign up for private insurance and tax subsidies to help pay for it.

And many will need help to do it.

That's where "Navigators" step in -- guides trained to help people understand their new options in the shifting world of health coverage.

The Navigator programs, which were announced in Tennessee just last month, have been scrambling to train their staff and get education efforts ramped up as the Oct. 1 start date looms.

But last-minute rules pushed by state officials could drag out that process.

Under emergency rules drafted by the Commerce and Insurance Department, Navigators and certified application counselors will have to go through a registration process that will include a criminal background check before they're allowed to help clients.

State officials say the rules are needed to protect consumers from "bad actors" who may abuse their access to people's private information.

But state Rep. JoAnne Favors, D-Chattanooga, called the new requirements "obstructionist," and another political attempt to block the rollout of the new health law in Tennessee.

"This is just another obstacle in trying to get people signed up on insurance," she said. "[Gov. Bill Haslam] has already chosen not to expand Medicaid. He already rejected running a state [insurance] exchange. Why on earth do they have to do this now? I am sick about it."

Kate Abernathy, spokeswoman for the Tennessee Department of Commerce and Insurance, said the rules will only help consumers, and called the new requirements "a very low barrier" process.

"These [Navigators] are going to be in our communities, acquiring sensitive information," said Abernathy, whose department drafted the emergency rules. "It would be very remiss of the state government to not protect our consumers."

The new rules will not be released to the public until they are sent to the attorney general's office for approval, said Abernathy. She said the department hopes that process will be done by October -- right when the new insurance enrollment starts.

Navigator programs are one of the latest arenas in the conflict over health reform. While federal law requires Navigators, it does not bar states from creating their own rules for the programs.

Other GOP-controlled states have called for stricter regulations on Navigators -- some so strict that critics call them deliberate tactics to sabotage the law.

Some, like Georgia's Insurance Commissioner Ralph Hudgens, haven't denied that.

In August, Hudgens told a group of Republicans his office was doing "everything in our power to be an obstructionist" to the law, according to the Atlanta Journal-Constitution.

Hudgens said he will require Navigators to pass a test that is basically the same as an insurance broker's test -- though federal law says Navigators are not brokers.

In Florida, state health department officials announced Wednesday that Navigators are not allowed to step foot on county health department property -- a heavy blow to outreach efforts, critics said.

House Majority Leader Gerald McCormick, R-Chattanooga, said Tennessee's new rules are "not some kind of attempt to stop the Affordable Care Act from coming in."

"It's just the state taking care of its responsibilities to protect our citizens," he said. "Anyone who's looking at confidential health records and tax returns should at least be able to pass a background check."

There are no tests in Tennessee's requirements, Abernathy assured. The Navigator groups the department has worked with have been receptive to the new rules, she said.

But Favors said adding another layer to the already-lagging process will stall enrollment at a time "when people are very anxious to enroll. We have been working so diligently trying to prepare."

Walter Davis, who heads the Tennessee Health Care Campaign, said he couldn't comment on the new rules until he saw them, but he said, "It's unfortunate they would introduce new steps within two weeks."

"It's a troublesome situation what's happened in Georgia," he said. "[The state] interrupted community efforts, and there's still public debate over what the new regulations mean."

But Davis' group is moving forward to prepare people for enrollment, he said.

"We're working as if the Oct. 1 start date is rolling out the way it's supposed to," he said.

Staff writer Andy Sher contributed to this report.

Contact staff writer Kate Harrison at kharrison@timesfreepress.com or 423-757-6673.

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