IN THE FIERCE debate over what would become the Affordable Care Act (ACA), the signature policy achievement of President Obama’s first term, there was relatively little to-do over the question of the bill’s so-called navigators.
These are members of advocacy groups and social service organizations charged with helping people decipher — or navigate — the ACA’s online health-insurance marketplace and then choose the best plan. This was among the most reasonable components of the act: Health care in this country is complicated, and having people help others work through the rules and regulations will allow many Americans — especially lower-income Americans — get the coverage they need.
But in the years since the ACA became law, navigators have become a major friction point in the push to unravel Obamacare in state legislatures across the country.
Insurance brokers and agents have led the charge, insisting that navigators will impede their ability to do business. For decades, agents argue, they have been the ones to sell insurance to individuals and small businesses and help them weigh their options (albeit for a fee).
Obamacare ultimately left control over navigator programs to the states, so insurance agencies and brokers have lobbied lawmakers to regulate the navigators and ensure that they cannot assume any of the roles traditionally filled by agents and brokers. According to a report by the Commonwealth Fund, these efforts have been remarkably successful: In the past 1½ years, more than 15 states, including Ohio, Texas, Florida and Virginia, have passed laws regulating navigators. In five others, legislation has been proposed but not yet been passed or has been passed but not yet signed by the governor.
These states make a credible argument that navigators — like doctors, lawyers and, yes, insurance brokers — should be subject to some oversight. But too many states have allowed insurance agencies to dictate the laws, inhibiting navigators from doing their jobs. Most of the states with these regulations on the books require navigators to undergo training in addition to the federal training they already must complete, often at their own expense. Many of the laws also prohibit navigators from advising people about the coverage details of certain plans, ostensibly in the name of preserving fair competition. It’s fair enough to prohibit navigators from endorsing one plan over another, but should they really not be allowed to advise consumers to consider all the variables?
The sad reality is that these regulations will make it harder for people to get the help they need. Millions of Americans already are at a disadvantage when it comes to accessing the health-care marketplace, and the Obama administration was right to include a provision in the ACA to assist them.