States Blocking The Health Care Door

Emily Foster

In just four days, uninsured Americans will finally be able to enroll in the Affordable Care Act’s new health exchanges. But Republicans in the states are engaged in shady efforts to block the operation of these exchanges in ways that affect millions of citizens.

They are imposing requirements that are not only exhaustive and unnecessary, but make it harder for the most vulnerable Americans to receive health care they desperately need.

A report released Thursday by the organization Health Care for America Now, “Anti-Obamacare States Try to Throw Navigators Off-Course,” did a detailed analysis of 13 states that have a total of 17 million uninsured Americans eligible for coverage as a part of the Affordable Care Act. Most of these states have rejected federal dollars to fully partake in the extension of Medicaid benefits for their millions of eligible citizens.

“Navigators” are people authorized under health care reform to provide “disinterested counsel” to consumers going through the enrollment process for the health care exchanges. The ACA created a program of federal grants to support individuals and organizations who were to provide this service.

They help people eligible for ACA benefits to determine whether to enter Medicaid or a private plan and help applicants sort through the various options of private health plans.

These navigators operating in the 34 federal and state partnership exchanges are required to complete 20 hours of training in topics such as the range of insurance programs, tax implications of enrollment decisions, eligibility and enrollment rules and procedures, privacy and customer service standards. They must also pass a certification exam, provide regular financial and progress reports, and submit to audits.

However, public officials who oppose the ACA in the 13 states in the HCAN study have been found to have established “navigator suppression measures.” They take the form of excessive requirements, including “residency rules, fingerprinting, extra fees, and superfluous certification exams and background checks.”

In Texas, for example, Gov. Rick Perry ordered Texas Insurance Commissioner Julia Rathgeber that rules for navigators should include “a minimum of 40 hours of state training, a difficult state examination, periodic background and regulatory checks, fingerprinting requirements, and associated fees for training and registration.” Texas currently has the highest population of those uninsured in the entire United States.

By blocking access to the Affordable Care Act, conservative officials are directly targeting and attacking Americans in need.

“Using a range of state laws and regulations, opponents of the ACA are resurrecting the civil rights resistance tactics of the 1960s, when state officials obstructed laws ending school segregation and guaranteeing voting rights,” the report said. “In recent years, many of the same states have passed laws to suppress voter registration and turnout among minority, low-income and elderly residents, as well as college students. The same dynamic is unfolding in 2013 as millions of Americans from many of the same demographic groups are poised to use the new ACA marketplaces to obtain affordable health insurance.”

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