PA lawmaker wants more oversight over Obamacare navigators

By Andrew Staub | PA Independent

Funded by a federal grant, the nonprofit Resources for Human Development has deployed 35 trained navigators across select Pennsylvania counties to help the most vulnerable residents enroll in Obamacare.

Laura Line is the corporate assistant director who oversees the navigator program for the Philadelphia-head-quartered human services nonprofit. She said the organization goes “above standard” by having the employees carry identification and undergo FBI clearances before they begin guiding people through the enrollment process.

That’s the sort of practices state Sen. John Eichelberger, R-Blair, believes should be the norm for the so-called navigators, who are tasked with helping people secure health-care coverage under Obamacare.

“Keep in mind this is public policy we’re setting,” Eichelberger said. “Just because one organization does something and uses best practices doesn’t mean that everybody does that. So, we’re concerned about setting the bar so that everybody operates on the up and up across the commonwealth.”

Eichelberger has proposed legislation requiring that health-care navigators pass a criminal background check and obtain a certification from the state Department of Insurance.

The bill requires training to distinguish the responsibilities of navigators from those of people licensed to sell and offer advice about insurance. It would also require education about privacy laws.

Eichelberger has described the legislation as an effort to protect consumers, especially because they give sensitive information to navigators tasked with providing reliable information about coverage. While navigators act like insurance agents, they have few restrictions or qualifications to follow, according to the lawmaker.

While testifying before the state Senate Banking and Insurance Committee, Pennsylvania Insurance Commissioner Michael Consedine said navigators can facilitate enrollment in qualified health plans, but they’re not allowed to sell, solicit or negotiate health-care policies.

“That is an area, though, where the lines get very blurred very quickly,” Consedine said, expressing concern that navigators might delve into complicated insurance issues without having the training and expertise of licensed insurance agents.

While Consedine said he has not seen abuses in the navigator position, he said the market is being monitored.

Line – who said Eichelberger’s proposal would add a duplicative process beyond federal certification requirements – indicated she hasn’t seen the potential for widespread fraud.

“We are not aware of it, and we’re very vigilant,” she said.

That doesn’t mean it hasn’t happened.

U.S. Rep. Joseph Pitts, R-PA, spoke to the committee via webcam and pointed to instances in California in which more than 40 navigators were found to have been convicted criminals. Offenses included forgery, welfare fraud and burglary, he said.

With no federal requirement that navigators undergo a background check or be fingerprinted, Americans who buy insurance can risk having their identity stolen after providing their personal information when trying to enroll under Obamacare, Pitts said.

Measures such as Eichelberger’s proposed legislation can help protect consumers, Pitts said.

“These seem like common-sense steps to protect Pennsylvanians where the federal government has failed to do so,” Pitts said.

Eichelberger has indicated he’s willing to tweak language in the bill after Wednesday’s public hearing. For now, Consedine would commit only to further discussion about Eichelberger’s bill.

State Sen. Anthony Williams, D-Philadelphia, hopes the Insurance Department eventually gets behind the legislation addressing the navigators.

“I don’t think we should be waiting for a whole slew of these opportunities to present themselves next year or two years from now when criminals can figure out how to use it, exploit it,” he said. “Then, all of a sudden, we’re unfortunately having to revisit this.”

Andrew Staub is a reporter for PA Independent and can be reached at Andrew@PAIndependent.com. Follow @PAIndependent on Twitter for more.