Health Care | Accountability

Policy Feature Issue: Obamacare Navigators

Policy • September 20, 2013

This past August, the Department of Health and Human Services awarded $67 million to organizations to further the Administration’s goal of implementing Obamacare. These organizations, know as navigators, are statutorily charged with, among other things, educating the public and facilitating enrollment in federal and state exchanges.[1]

The grants, $13 million more than previously announced, are intended to help enroll as many Americans as possible beginning on October 1 and over the next six months.  CBO estimates that seven million individuals are likely to enroll in exchanges in 2014.[2]  Yet, to stay financially viable, exchanges must enroll enough young people to even out premium costs. [3]

However, the navigator program, like the rest of Obamacare, is fraught with problems.  Less than two weeks before the start of enrollment, the Department of Health and Human Services has yet to implement or identify any mechanism to protect Americans from fraud, waste, or abuse.

According to a recent report issued by the Committee on Oversight and Investigations[4]:

  • The Department of Health and Human Services decided against providing prospective consumers of health insurance with a list of certified navigators or in person assistors.
  • The Department of Health and Human Services rejected requiring that navigators or in-person assistors undergo background checks – allowing convicted felons, including those convicted of identify-theft, to acquire sensitive personal information.
  • The Department of Health and Human Services has yet figure out a way to avoid incidents of fraud or identify theft associated with navigators and assistors and have admitted there is no way to verify whether navigators are legitimate or associated with specific organizations.
  • The Department of Health and Human Services has yet to provide information or standards preventing self dealing or conflicts of interest.
  • The Department of Health and Human Services continues to relax its training standards – going from 30 hours of training to 5-20 hours and even allowing navigators to begin work without completing training.

A letter to the Administration signed by 13 Attorneys General makes clear that the navigator program poses significant risks to consumer privacy. [5] The Federal Trade Commission is concerned[6] as well as the 16 states that have already enacted more stringent requirements on “government-funded helpers.”[7] The Administration should be too. Yet, it’s made clear that enrolling individuals in exchanges is their number one priority – even if it makes Americans and their personal information less secure.

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