The Oversight and Investigations subcommittee recently questioned a CMS Deputy Director about the Navigators program. The initiative is designed to grant community outreach organizations funds to reach out to consumers and inform them about the health insurance marketplaces.
Hearing Date: September 19, 2013
Hearing Summary: Prepared for AAPS by the Market Institute
The Oversight and Investigations subcommittee recently held a hearing to examine the readiness of the Affordable Care Act and to question a witness from Centers for Medicare and Medicaid Services. In his opening statement Chairman Tim Murphy stated his uneasiness about the healthcare law and whether it will actually be ready for implementation when the Administration says it will be. The Navigator program, a grant program designed to reach out to communities and individuals, is a principal concern based on the expenditures of taxpayer dollars and questionable practices by Navigators themselves.
Rep. Henry Waxman (D-CA) said in his opening statement that the oversight of the ACA thus far has been an attempted undermining of the law by Republicans. There is no point to the 51 letters sent out to Navigators which are food banks, community groups, and non-political organizations tasked to inform the public about the ACA. He said the letters are designed to waste their time answering questions when they could be doing their jobs spreading the word about the ACA and marketplaces.
Rep. Michael Burgess (R-TX) recounted in his opening statement the recent history of the Navigators program. Funding was months late and the training program for Navigators has not yet been fully implemented.
The lone witness, Gary Cohen, Deputy Director, Center for Consumer Information and Insurance Oversight at Centers for Medicare and Medicaid Services testified in his opening statement that mandatory rate reviews of 10% or higher on health premiums has led to a savings of $1.2 billion for Americans. Educating consumers and businesses is a key step in successfully establishing the marketplaces. Earlier this year, CMS restarted their 24 hour call center, Healthcare.gov which consumers can call and get information on choices and also report incidents of fraud. In addition to over the phone and online assistance, CMS is funding Navigators to assist consumers with in person visits. Navigators are trained to provide assistance and inform people about the marketplaces. They are required to complete 20 hours of training and also adhere to strict privacy and security guidelines regarding consumer information.
In response to questioning, Gary Cohen said:
- Consumers will be able to go online October 1st and see prices for insurance
- Navigators are bound by law to not share information about consumers; they face a $25,000 fine if they do
- Navigators will be instructed to not go door to door
- It is his understanding all states that have their own marketplaces will be ready for coverage on January 1st
- CMS will be doing oversight of the Navigator program, possibly using “secret shopper”
- Navigators will not be asking consumers for information about their health
- There is no requirement for criminal background checks for Navigators because CMS was concerned about their authority, so they left that up to the states
- Navigators will not be paid per enrollee they sign up
Hearing Website
http://energycommerce.house.gov/hearing/two-weeks-until-enrollment-questions-cciio
Testimony:
Mr. Gary Cohen
Deputy Administrator and Director
Center for Consumer Information and Insurance Oversight
Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
