The House Committee on Energy and Commerce held an oversight hearing on Thursday, September 19, during which they took the testimony of Gary Cohen, the Director of the Center for Consumer Information and Insurance Oversight (CCIIO) at the federal Department of Health and Human Services (HHS). Although billed as a general hearing on the Administration’s readiness for the launch of the health insurance marketplaces under the Patient Protection and Affordable Act (ACA), the primary focus of members’ questioning was the law’s Navigator Program, which was authorized under the ACA and designed to serve as the bridge between the health insurance marketplace and the consumer, to help guide consumers through the new health insurance landscape.
Somewhat surprisingly, the Navigator Program has become the focal point of attacks by many opponents of the ACA. For example, the leadership of the Energy and Commerce Committee recently initiated an investigation of fifty-one Navigator Program grantees and asked that they turn over voluminous paperwork and respond to a detailed series of questions, an investigation that a minority member of the Committee called “groundless.”
Members of the Committee continued their attack on the Navigator Program at yesterday’s hearing, with a series of tough questions for Gary Cohen. Of particular concern, apparently, is the risk of fraud by navigator grantees and even criminal activity. In addition, Congressman Murphy criticized CCIIO for delays in the funding of navigators and their training. Congressman Burgess called for the navigator grants to be “returned to the taxpayers.” Another member, Congressman Scalise, was singularly focused on the fact that the federal government does not require individual background checks for each navigator and tried repeatedly to get Mr. Cohen to “admit” that the federal government’s rules allow someone convicted of identity theft to become a Navigator.
In response to the multitude of questions about the integrity of the Navigator Program, Mr. Cohen said, “I find the suggestion that these organizations … are going to prey on people by stealing their identities to be utterly without foundation.” According to Cohen, navigators have been screened by HHS’ office of grants management and then evaluated by an independent panel of reviewers. In addition, part of the application process requires applicants to the Navigator Program to establish their existing ties to the community. These navigators are mostly drawn from non-profit groups like food banks, community health centers, hospitals, and other community service providers, with long experience assisting people with enrollment in public programs, like Medicaid or other public health insurance coverage, and other assistance or counseling programs.
A number of Committee members have pointed out that “there is no evidence of any malfeasance from any of the organizations” and that there is no reason to think that these programs will be overrun with criminals and scammers. Representative Green put his colleagues’ concerns over background checks in a broader context, noting that private insurance agents and brokers do not, under federal law, have to undergo background checks. Mr. Cohen confirmed this, noting that the federal government does not have the authority to require such checks and this area of regulation has traditionally been the province of the states.
Others suggested that the concerns raised at yesterday’s hearing about the Navigator Program were part of a broader effort by ACA opponents to undermine the law and hinder its implementation. One minority member said of ACA opponents, “they keep attacking the ACA and they want to confuse people, they want to scare people, and this is what this hearing is all about…this is nothing but intimidation by this committee….”
Indeed, California Rep. John Campbell admitted to reporters prior to the hearing, “There is not a single person in the Republican conference that does not want to repeal Obamacare in its entirety tomorrow….The question is, what is the best way to try to accomplish that or as close to that as we can get?” The “as close to that as we can get” at this stage appears to be an effort to discredit the navigator program and make it more difficult for people to get the help they need to enroll in coverage through the health insurance marketplaces.