Navigators Under Investigation

Well, we knew it would happen. The navigator program has failed to live up to the vision that the administration and other supporters of the Affordable Care Act had for it. Navigators, of course, are charged with helping people enroll in qualified plans through the exchange, but these individuals and organizations are usually unlicensed and, it appears, untrained.

The House Oversight and Government Reform Committee, chaired by Republican congressman Darrell Issa, has been investigating “recent reports of fraudulent activity related to the ObamaCare navigators program” and, specifically, “how Texas officials are responding.” That’s according to a December 13th news release from the committee.

The Committee held a field hearing in Richardson, Texas, just outside of Dallas, yesterday. From the Chairman’s Hearing Statement:

The Chairman goes on to say that navigators in Dallas have been “caught on camera advising individuals to commit tax fraud by under reporting income in order to gain higher subsidies” and that, in Florida, someone impersonating a navigator “gave a television interview in which she told viewers blatantly incorrect information: that applicants’ credit scores could impact their eligibility for certain plans.”

The Dallas Urban League, which received $376,000 in federal funds for its navigator program, was invited to speak at yesterday’s hearing, but the organization’s CEO Beverly Mitchell-Brooks was unavailable to testify. As Issa points out, Dr. Brooks’ “refusal to provide Congress with answers to our questions about the Navigator program only serves to increase our concerns.”

Brooks is not the only one refusing to provide the Oversight Committee with requested information. Politico reports in an article entitled HHS to Darrell Issa: We don’t trust you that HHS “told House Oversight and Government Reform Committee Chairman Darrell Issa that it won’t turn over documents related to the security of the website because it can’t trust him to keep secret information that could give hackers a roadmap to wreak havoc on the system.”

The administration is concerned that Issa has been ” loose with sensitive information in the past” and refused to provide the documents despite a subpoena.

What this means for agents

In general, navigators are trying to do the right thing, and they’re focused on a different segment of the community than brokers, though there is certainly some overlap. But, as we all know, one bad apple can spoil the whole bunch, and that seems to be what’s happening with the navigator program – there are enough reports of fraud and abuse to scare the public, and that can help brokers explain the value that they provide.

Brokers who have teamed up with HPA to provide a private exchange site to their clients have two strong selling points: 1) the technology is much more user-friendly than the site or most state exchange websites, and 2) individuals who need assistance can talk with licensed health insurance agents rather than unlicensed navigators (whether the broker is working the leads directly or having them routed to the call center).

Reports of continued problems with the site and growing concerns over the navigator program only serve to strengthen that argument.

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