The CPI piece is timely in view of Secretary Sebelius’s recent announcement of $67 million in grants to help 105 organizations—like Mercy Hospital and Medical Center in Illinois and Planned Parenthood of Northern New England in New Hampshire—set up navigator programs. The grant money was borrowed from a special fund to promote health prevention that was also created by the ACA. Navigators are to receive at least 20 hours of training and pass a certification test. How good this training will be and how much is really necessary is anyone’s guess at this point. Navigators can be paid employees or volunteers, says Washington and Lee law professor Timothy Jost. “I don’t think anything in the law prohibits an agency from paying navigators an incentive for signing people up, as long as none of it comes from an insurance company, but I think it would not be a good idea,” he told me. “It would encourage navigators to go for signing up as many as possible rather than making sure the people they sign up understand what they are doing.” Precisely. That’s the incentive old fashioned brokers and agents have. They earn commissions. The more sales, the greater their income.

Here’s where we in the press come in. Both the CPI story and government’s release of the names of the groups offering navigator programs give us an opening for good and helpful reporting. There are at least two ways journos can take this story. For one, in the states that don’t have their own requirements for regulating navigators, it’s a good bet the brokers and the NCOIL will still be hard at work trying to make sure they do. That’s a political story that raises the question of whether navigators need more training and more restrictions.

Another angle for reporters is basic consumer stories. In my experience, I have found good and bad insurance brokers. Even when it comes to more neutral types—that is, those who don’t have a sales commission to worry about like the Medicare counselors in the State Health Insurance Assistance Program (SHIP) program—there are good and bad advisers. One way for reporters to sift the good from the bad is to understand the products that each group will be pushing. Once you do that, visit the groups in your area that have received navigator grants. Interview officials, learn about the compensation for the navigators as well as their goals and sign-up quotas (if there are any). Learn what the training requires—do navigators need more of it, as brokers claim? Sit in on a call from a consumer asking for help. What is it that shoppers don’t understand? Are the navigators providing decent answers? While this may sound like a bit of hard, time-consuming work, it’s a way to move beyond the spin and the politics that are sure to surround the state exchange enrollment process.

Follow @USProjectCJR for more posts from this author and the rest of the United States Project team. And for Trudy Lieberman’s resource guide to covering the ins and outs of buying insurance on the state exchanges, see Open Wide, from CJR’s new July/August issue.

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Open Wide

Exchange Watch: Nevada

Exchange Watch: Missing in Montana

 

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.