State issues rules for Obamacare ‘navigators;’ complaints ensue

Representatives of organizations seeking to help the uninsured sign up for health coverage under the Affordable Care Act reacted with dismay, anger and disappointment Thursday when Tennessee issued emergency rules restricting their activities, reports The Tennessean.

The rules require their employees and volunteers to be fingerprinted, undergo background checks and limit the advice they can give to people. The Tennessee Department of Commerce and Insurance said the agency is protecting consumers from fraud, but religious and social service leaders question the motive.

The rules were issued less than two weeks before the Oct. 1 launch of the Health Insurance Marketplace, where the uninsured can shop for policies and possibly qualify for subsidies toward buying coverage. Organizations are uncertain how to comply and worry that it will delay their work.

“It binds people’s hands to bring about resources that can actually impact someone’s journey of health or illness purely for political motivation,” said Timm Glover, chief mission and ministry officer for Saint Thomas Health. “It has no concern for the common good of society. It flies in the face of human dignity.”

And critics of the rules say they don’t protect anyone from fraud because scammers aren’t going to register with the state.

Bipartisan legislation overwhelmingly passed by the legislature this year authorized the state agency to regulate navigators and certified application counselors. Navigators are tasked with doing outreach activities to inform people about coverage opportunities, while counselors can help them apply for coverage. The state law prohibits them from selling, soliciting or negotiating any insurance policy.

It sets a penalty of up to $1,000 for each violation.

“I guess the question we’re asking is, ‘Where does it stop?’ ” said the Rev. Merrilee Wineinger, coordinator of holistic living and outreach for the Tennessee Conference of the United Methodist Church. “The state is coming in and telling churches that they can’t counsel. It’s something that we have been doing so long. They are regulating how we do ministry. Where does it stop?”

The regulations did not undergo any public hearings because they were issued as emergency rules, said Beth Uselton, a program officer with Baptist Healing Trust.

Note: The Commerce and Insurance news release is below.

News release from state Department of Commerce and Insurance:
NASHVILLE – The Department of Commerce and Insurance (TDCI) issued emergency rules this morning aimed at protecting Tennesseans seeking health insurance coverage through the federally facilitated marketplace (FFM), or “exchange.” The emergency rules implement Public Chapter 377 by establishing registration requirements for navigators and certified application counselors designated under the Affordable Care Act (ACA) with the responsibility to assist consumers access the FFM.

Commissioner Julie Mix McPeak said, “Beginning October 1, many Tennesseans are expected to review health insurance options for 2014 through the federally run exchange. TDCI’s emergency rules will ensure that the people representing themselves to consumers as exchange experts have completed federal training courses and related examinations, where appropriate, and that they have passed a criminal background check.”

“Navigators and certified application counselors will have access to consumers’ most personal information—including tax returns, social security numbers, and health history,” said McPeak. “It is incumbent on us, working to implement the will of the General Assembly, to ensure that individuals who are not of good moral character cannot act as navigators or counselors in this State.”

Commissioner McPeak said, “The Department designed the rules to protect consumers without obstructing individuals and entities planning to act as navigators and certified application counselors. The rules erect a low barrier to entry, to be followed by continuing education on the part of navigators and certified application counselors, and protect consumers from unscrupulous dealers.”

The emergency rules require navigators and certified application counselors to register annually with TDCI. Among other things, the rules require that a navigator or application counselor must be 18 years of age and must have successfully passed the federal training program. The rules require navigator and certified application counselor applicants to successfully complete a criminal background check and prohibit convicted felons from acting as navigators or certified application counselors. Navigators and certified application counselors are also prohibited from acting as insurance producers under the rules, unless they are also licensed as insurance producers.

The FFM open enrollment period for 2014 begins October 1, 2013, and ends March 31, 2014. In future years, the open enrollment period is scheduled from October 15 through December 7. Individuals may qualify for special enrollment periods if a qualifying event should happen outside of specified enrollment periods.

Public Chapter 377, SB1145, passed the Senate 28-1 and the House of Representatives 87-0, on April 8th and 16th, respectively.