The WasteWatcher: The Staff Blog of Citizens Against Government Waste

The Flights of the Navigators

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.


You might think I am going to talk about the 1886 movie, “The Flight of the Navigator,” but in this case, you would be wrong.  I recommend you spend some time reading Paul Bedard’s column today in the Washington Examiner where he discusses the tens of thousands of “Navigators” that will be hired to help people sign up for Obamacare starting this October.  He gives a nice overview of more madness coming from the statist’s dream on what government-run healthcare should look like.  Not only is it becoming increasingly clear that Obamacare is complex, it’s a job’s bill too!  (Which led me to think about the old Milton Friedman quip about removing dirt and spoons -- but I digress.) The Center for Medicare and Medicaid Services just released ANOTHER regulation – 63 pages in length (there are already 20,000 pages of regulations so far for Obamacare) that provides the standards for Navigator and non-Navigator personnel.  Huh, you say, what are Navigators and what will the regulations do? Well, according to the regulation what Navigators will do is provide help with the Exchanges.  The regulation says:

Consumers can receive assistance from a variety of sources when seeking access to health insurance coverage through an Exchange. Sections 1311(d)(4)(K) and 1311(i) of the Affordable Care Act, and the regulation implementing those provisions, 45 CFR § 155.210, direct all Exchanges to award grants to Navigators that will provide fair and impartial information to consumers about health insurance, the Exchange, QHPs, and insurance affordability programs including premium tax credits, Medicaid and the Children’s Health Insurance Program (CHIP); and that will provide referrals to consumer assistance programs (CAP) and health insurance ombudsmen for enrollees with grievances, complaints, or questions about their health plan or coverage. Navigators are an important resource for all consumers, particularly communities that are under-served by and under-represented in the current health insurance market. Navigators will not make eligibility determinations and will not select QHPs for consumers or enroll applicants into QHPs, but will help consumers through the eligibility and enrollment process. The Exchange regulations, at 45 CFR § 155.400(a), state that “[t]he Exchange must accept a QHP selection from an applicant . . . and must–(1) Notify the issuer of the applicant’s selected QHP; and (2) Transmit information necessary to enable the QHP issuer to enroll the applicant” (emphasis added). Additionally, as articulated in 45 CFR § 155.310(d), the Exchange is responsible for making eligibility determinations. Taken together, these regulations clearly mean that the Exchange, not Navigators, must determine eligibility and enroll applicants into QHPs. Additionally, a Navigator cannot make the decision for an applicant as to which QHP to select. That said, Navigators may play an important role in facilitating a consumer’s enrollment in a QHP by providing fair, impartial, and accurate information that assists consumers with submitting the eligibility application, clarifying the distinctions among QHPs, and helping qualified individuals make informed decisions during the health plan selection process.

Got it?  Don't want you to be confused.  And the purpose of the reg:

The proposed regulations would create conflict-of-interest, training and certification, and meaningful access standards applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State-based Exchanges that are funded through federal Exchange Establishment grants. These proposed standards would help ensure that Navigators and non-Navigator assistance personnel will be fair and impartial and will be appropriately trained, and that they will provide services and information in a manner that is accessible.

All clear now, right?  I hope so because according to Organizing for Action, Obamacare is going to make “the health insurance system work better for everyone.”  Yup, it is so good that taxpayers will have to pay people probably somewhere between $20.00 to $48.00 an hour (see page 39) to help citizens navigate and work their way through Obamacare to find a plan.  Navigators cannot recommend a health plan or determine whether you are eligible for a plan but what they will do is provide:

information and services in a fair, accurate, and impartial manner, including information that acknowledges other health programs such as Medicaid and CHIP; facilitating selection of a QHP; providing referrals for consumers with questions, complaints, or grievances to any applicable office of health insurance consumer assistance or health insurance ombudsman established under section 2793 of the Public Health Service Act (PHS Act), or any other appropriate state agency or agencies; providing information in a culturally and linguistically appropriate manner, including to persons with limited English proficiency; and ensuring accessibility and usability of Navigator tools and functions for persons with disabilities.

Doesn’t it make you feel warm and fuzzy all over? So what’s a Navigator?  Well that was already determined in a prior regulation, 45 CFR § 155.210(c)(2).  Here is what they can be:

Community and consumer-focused nonprofit groups; Trade, industry, and professional associations; Commercial fishing industry organizations, ranching and farming organizations; Chambers of commerce; Unions; Resource partners of the Small Business Administration; Licensed agents and brokers; and other public or private entities or individuals that meet the requirements of this section. Other entities may include but are not limited to Indian tribes, tribal organizations, urban Indian organizations, and State or local human service agencies.

The “Affordable” Care Act or Obamacare requires ALL Exchanges, the “super-markets” where citizens will be able to purchase health insurance, to award grants to Navigators.  This includes the state-based Exchanges as well as the Federally-controlled or state-federal partner Exchanges.  Sounds like a clever transfer of a whole bunch of taxpayer money to community groups – you know – more of that “spreading the wealth around.” Yet another reason why many smart governors across the country are having nothing to do with setting up an Exchange in their state and are leaving it to the feds to run the Obamacare.

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