Affordable Care Act navigator roles debated in Florida

Herald/Times Tallahassee bureauSeptember 24, 2013 

Scott Taxes

Florida Gov. Rick Scott addresses attendees of the Americans for Prosperity Foundation's Defending the American Dream Summit in Orlando, Fla., Friday, Aug. 30, 2013.(AP Photo/Phelan M. Ebenhack)

PHELAN M. EBENHACK — AP

TALLAHASSEE -- As the Oct. 1 rollout of the new health insurance marketplace draws near, the controversy over the insurance outreach workers known as navigators is building to a crescendo in Florida.

But is the outcry warranted -- or political theater aimed at hampering the Affordable Care Act?

Gov. Rick Scott and Attorney General Pam Bondi, both Republicans, have repeatedly blasted the navigator program, saying the outreach workers will have unreasonable access to private information. What's more, the state Department of Health said privacy con

cerns prompted a decision to ban navigators from county health departments.

"We're warning people to be careful because they're going to have your personal information and we're having a hard time getting answers," Bondi told Fox News last week.

Supporters of the federal law, however, point out a recently passed Florida law sets up some privacy safeguards for consumers by requiring navigators to undergo background checks. The law also enables state officials to establish rules and dismiss navigators who violate them.

"Elected officials, particularly Rick Scott and Pam Bondi, are going out there and making it seem like there is no protection for citizens," said House Minority Leader Perry Thurston, D-Fort Lauderdale. "The truth is, we put in some major regulations for who can become a navigator. They are creating a false sense of alarm."

The navigators will begin enrolling people nationwide next week with the launch of the new insurance marketplaces known as exchanges. The enrollment period will run for six months from Oct. 1 to March 30.

Agencies in Florida won $7.8 million in federal grants to hire, train and supervise outreach workers. More than half went to the Covering Kids & Families Program at the University of South Florida. Several grant recipients will focus on Miami-Dade and Broward, including the Epilepsy Foundation of Florida and Advanced Patient Advocacy LLC.

Across Florida, navigators will have to comply with Senate Bill 1842, which became law earlier this year.

The measure requires navigators to register with the state Department of Financial Services, and allows the department to review an applicant's "qualifications, residence, prospective place of business, and any other matters that, in the opinion of the department, are deemed necessary or advisable for the protection of the public and to ascertain the applicant's qualifications."

"The registration process is set up much like agent licensing, except the federal government provides the training," State Insurance Commissioner Kevin McCarty said at a Cabinet meeting last month.

The law also allows the department to "adopt rules establishing specific penalties against registrants" in order to "deter behavior incompatible with the public health, safety, and welfare."

As of Monday, the Department of Financial Services' Division of Agent and Agency Services had approved just one of the 43 navigator applications, communications coordinator Matthew Guy said. The other applications were pending.

Guy said the division had also begun establishing penalty guidelines.

"I believe the Legislature crafted the language quite well," he said. "We do have great authority to sufficiently regulate the navigators. Even if the rules aren't in place by Oct. 1, we still have statutory authority to take action."

Republican state Rep. Matt Hudson of Naples also praised the measure while testifying before Congress last week.

Still, navigators will not allowed to help people on the grounds of county health departments, due partly to concerns consumer information will be gathered for use in a federal database, Florida Department of Health spokeswoman Ashley Carr said last month. Department officials later noted all "outside organizations" are prohibited from using health department office space and information technology systems. Pinellas County officials objected on grounds the county owns the health buildings.

The privacy issue made headlines again last week, when Scott penned a letter to top congressional leaders.

"Floridians should not have to exchange their privacy for insurance," he wrote.

A spokesman for the governor said Scott's issues have been directed at the federal legislation, which does not include the safeguards written into Florida law.

"We had never expressed concerns with the state legislation," spokeswoman Jackie Schutz said.

A Bondi spokeswoman said her boss was taking an in-depth look at the Florida law.

"We will be in communication with [Chief Financial Officer] Jeff Atwater's office and the Legislature as the Affordable Care Act and Senate Bill 1842 are implemented, especially in light of the federal government's failure to adequately train and screen navigators and other health insurance assisters," spokeswoman Jennifer Meale wrote in a statement.

Critics such as state Rep. Mark Pafford, D-West Palm Beach, say the fuss over privacy doesn't make sense.

"They may have done something right in protecting Florida consumers," Pafford said of the state's Republican lawmakers and governor. "Now it seems that they are returning to political rhetoric."

Herald/Times staff writer Tia Mitchell contributed to this report.

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