Amid Political Controversy, Texas Approves new Rules for ACA Navigators

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Yesterday, the Texas Department of Insurance approved a new set of rules to regulate the state's ACA navigators, the individuals tasked with assisting consumers with purchasing health insurance through the new Affordable Care Act insurance exchanges. The new rules include background checks for those who wish to be navigators, and a mandatory 20 hours of state-specific training in addition to the training they're already required to get per the ACA.

The new navigator rules have been fraught with controversy. Shortly before the launch of the site, Governor Rick Perry instructed TDI commissioner (and Perry appointee) Julia Rathgeber to institute strict regulations on navigators, including an additional 40 hours of training and a costly navigator registration fee. The new, softer rules will save the nonprofit organizations who employ navigators thousands of dollars.

Given the timing of the proposed rules, and what Governor Perry stands to politically gain from hurting the Affordable Care Act, many Democrats alleged that the navigator rules were politically motivated and not in the best interest of Texans. Republicans countered that they were trying to protect consumers from identity theft. However, Rep. Lon Burnam (D-Fort Worth) discovered internal documents that proved that the TDI rules were politically motivated and would have made them subject to legal challenges. After Burnam threatened to make the documents public, TDI relented and approved the lighter rules.

Read what Rep. Lon Burnam and other community leaders had to say about the new navigator rules after the jump.In a press statement, Rep. Burnam criticized TDI's politically motivated actions and secrecy:

We shouldn't play political games with people's healthcare. There was no justification for the original proposal other than conservative politics, so I'm glad TDI has relented and come up with training requirements that are at least somewhat logical. … I don't think public-funded agencies should be keeping secrets from the public. And if someone wasn't going to subpoena my office to force me to release those secret documents, well, they may have found their way out anyway. … I put TDI on notice and also alerted anyone wishing to file a lawsuit over the rules that these documents existed. I think I accomplished my task.”

Rep. Garnet Coleman (D-Houston) expressed his disappointment that these new rules, though less harsh than before, will still get in the way of many Texans' ability to get health insurance:

“If you're an advocate for limited government and less bureaucracy, then you should be as disappointed as I am about the new Navigator rules. With these new rules, Governor Perry has brought his fight against needy Texans to those who are middle and working class. Texas leads the nation in the percentage of people lacking health insurance, and the Governor is finding more ways to make it harder for Texans to sign up for coverage.

Without working with CMS, TDI misconstrued its legislative authority and has imposed strict requirements on Texas Navigators. The new regulations will frustrate the ability of Navigators to register and legally operate in this state, making it that much harder for ordinary Texans – many of whom have never been covered before – to apply for coverage.

The rules are not realistic. They prohibit individuals from helping a friend or significant other from signing up for coverage on the exchange. While exceptions exist for spouses and close family, that still leaves a lot of close relationships that Texans will be barred from assisting. The new rules also require 20 hours of state-level training on top of the already existing 35 – 40 hours of necessary federal training. There is simply no reason for this requirement other than to make it harder for Navigators to organize and help Texans obtain health coverage.  The rules are simply not appropriate for a state with over 6 million uninsured residents.”

State Senator Sylvia Garcia (D-Houston) testified before the Texas Department of Insurance during its January 6 hearing regarding navigator rules. In a statement released yesterday, she acknowledged that the new rules were a step up from the original proposal, but will still impose undue burdens on navigators:

The final rules are an improvement over what was initially proposed, but there are still some challenges ahead. I still believe that the rules are burdensome, costly and create obstacles in our goal of reducing the uninsured rate in Texas.

I thank Commissioner Rathgeber for listening to the public's feedback.  Specifically, I'm pleased that the rules reduce the Texas-specific training hours to 20 hours, eliminate the $50 registration fee, reduce the surety bond requirements for navigator entities and clarify that navigators can provide advice and guidance to consumers.

However, the effective date of March 1 for most of the requirements and May 1 for the 20 hours of training is still a major concern. And, frankly, while some expenses have been eliminated or reduced, there are still extra costs associated with these rules that are still burdensome to navigators.  I am extremely concerned about where the navigator entities will find the additional funding to cover these costs. Also, it doesn't appear that TDI specifically addressed my request to permit extended exam time for those who speak English as a second language. Currently, the federal government does allow this accommodation for the federal exam.

My first and foremost concern is for the people of Texas. I want our navigators to be well trained and prepared, and I want to reduce the number of uninsured Texans.

Ginny Goldman, Executive Director of the Texas Organizing Project also expressed concern with the rules, and reminded Texans of what's at stake this year:

“The rules released today will still impose unnecessary burdens on health insurance navigators, but they are better than the onerous regulations recommended by Governor Perry and Attorney General Greg Abbott, whose main interest seems to be scoring political points, not helping Texans get health care.  It's clear that the Texans who spoke out – including the dozens of TOP members who attended a public hearing in December – have helped make a difference.

This entire process has proven two things:  first, it's vital that the Texas Organizing Project continue our successful efforts to reach out and let Texans know about the new health care law and second, Texans need to send new leaders to Austin this November.


About Author

Katie Singh

Katie grew up in Austin and has been involved in Texas politics since 2004. She has been a part of several campaigns, from state house races to working at President Obama's campaign headquarters in 2012. She loves public policy, public health, and tacos. Katie tweets from @kasingh19.

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