The WasteWatcher: The Staff Blog of Citizens Against Government Waste

Navigating Healthcare Privacy

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.


The Department of Health and Human Services (HHS) has awarded $67 million in grants to more than 100 organizations to assist individuals needing help navigating the confusing process of signing up for Obamacare.

On August 14, 2013, the attorney generals of 13 states sent a letter to HHS Secretary Sebelius, raising apprehension about what they view as inadequate privacy protections in implementation rules issued by HHS for the healthcare navigator program.  Among the AGs concerns were that HHS’ rules were deficient in protecting personal information for consumers, how personnel would be screened prior to having access to this information and providing notices to consumers about their privacy rights when they receive assistance from the patient navigators.  Additionally, the AGs asked the Secretary to provide more information on what kind of guidance would be provided to program personnel and the role state regulatory agencies would play in supplementing federal data privacy requirements in the exchanges.

While only 20 hours of training is required for each navigator to participate in the program, organizations are not required to perform any background investigation or other screening, despite the fact that these individuals will be privy to taxpayer’s personal identifying and medical information when signing them up for Obamacare.

On August 29, 2013, members of the House Committee on Energy and Commerce signed a letter mailed directly to organizations receiving federal navigator grant awards.  The letter asked the organizations to provide information about how they would use the grant funding, how they would protect personal identifying information of those they would assist, and what kind of training the navigators would receive.

On September 3, 2013, The Heritage Foundation released a report that discussed the ramifications of the lack of privacy with both the data hub that will provide access to government data on individuals, such as tax and Social Security records to use in checking for eligibility for subsidized insurance, and the use of navigators to help individuals sign up for coverage.  The report points out that states are permitted to establish minimum eligibility criteria and background checks for the navigators.

One such state considering this option is California, which found that requiring health insurance agents to undergo fingerprinting and background investigations every two years has helped to reduce the number of fraud and improper handling of paperwork.  Since January 2011, the state revoked the licenses of 514 insurance agents or brokers for misrepresentation, fraud or improper handling of premiums.

On September 9, 2013, AP Wire Service reported that not all of the organizations receiving these federal grants will be ready to assist potential enrollees by the October 1 deadline.   Hiring and training individuals to properly protect personal identifying information and health care information takes time, yet many of the organizations receiving the navigator grants have had a small window in which to hire and train employees.

On September 17, 2013, the Journal News in New York reported that even with the October 1 deadline looming ahead, the healthcare navigators are unprepared to help taxpayers.  It is apparent that Obamacare is not ready for prime time, yet the administration is forging ahead with the mandate that requires uninsured individuals purchase health insurance or pay a tax (fine).  You may recall that in early August 2013, the administration delayed the employer mandate that requires an employer with more than 50 employees to provide health insurance coverage.

While repealing the entire law is the best policy, at minimum, rather than rushing implementation and putting the personal identifying and healthcare information of taxpayers at risk, the government should slow down implementation where possible in order to ensure that appropriate background checks and privacy training occurs in the healthcare navigator program.  Additionally, for transparency in spending taxpayer dollars, organizations receiving federal funds for this program must share with Congress how they plan to perform these tasks and how the funds they receive will be spent.

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