Thanks to The Center for Public Integrity, we now have a substantial story that tells us about the latest Obamacare turf wars. As we well know, turf wars among professionals are all about protecting incomes, and when the bottom line is involved, the fighting gets fierce. This one is over who’s best to advise those 24 million souls who will buying insurance in the state insurance exchanges this fall and beyond.
Traditional insurance agents and brokers who’ve sold health insurance for years have been arguing since the debate on the Affordable Care Act began that they are best to help confused consumers sort through the myriad options they’ll confront. The crafters of the ACA thought otherwise, and called for a system of navigators fanning out all over America to get folks signed up. Secretary of Health and Human Services Kathleen Sebelius wants seven million people enrolled in state exchanges by the end of March 2014, when the open enrollment period for signing up is over. And when there are money and quotas involved, there are bound to be, shall we say, questionable sales practices. This happened when the Medicare prescription drug law took effect in 2006. Given the high stakes, there’s no reason to think this effort will be any different.
Since the Affordable Care Act passed in 2010, insurance brokers and agents have embarked on a state capitol strategy to stymie the navigators, and their quiet campaign has largely eluded the press (not surprising, given diminished statehouse reporting). Their campaign has resulted in laws in 16 states over the past year to restrict the activities of the navigators who are supposed to help people enroll in the exchanges. Tom Corwin, a staff writer for the Augusta Chronicle, has covered the story in Georgia’s capital, and in one piece quoted Katie Keith who has tracked state laws for Georgetown University’s Health Policy Institute. “I will say [these laws] are strikingly similar across the states, which does suggest that somebody is pushing them,” she told Corwin.
That somebody, according to the Center for Public Integrity, is an influential group called the National Conference of Insurance Legislators (NCOIL), made up of state lawmakers who hold hearings, debate policy, pass resolutions, craft model laws, and send articles, research reports, and alerts to fellow state legislators. They also hobnob with members of the insurance industry who pay big bucks to attend the group’s conferences and events. It’s the kind of symbiotic relationship that’s prevalent among the regulated and the regulators. Only in this case it’s the legislators who pass the insurance laws.
A member of the group, North Dakota state representative George Keiser, told the Center that insurance agents and brokers approached him with concerns about the navigators early in 2012. Keiser crafted a resolution, which the NCOIL group adopted this spring. The states that have passed broker-backed legislation pretty much have followed Keiser’s resolution. It calls for states to require their own training and licensing requirements for navigators, bars them from recommending specific insurance plans, and calls for background checks. Georgia’s law, for example, requires navigators to undergo background checks and prohibits them from giving advice about the benefits, terms, and features of a particular health plan. Federal officials have said states can impose extra requirements as long as they are not a “hindrance” to the navigators doing their jobs. Georgia requires navigators to have 35 hours of training.