Georgia broker Maggie Coley rejects the idea that agents pushed for the law to “punish navigators in doing their business. The reason that brokers in Georgia (backed the legislation) was to protect consumers,” she said. “We felt (navigators) needed to be overseen, have training, continuing education and background checks … to make sure they weren't going to be rogue salespeople.”
In December 2012, HHS issued guidance saying that states with federal exchanges can impose navigator-specific licensing or certification requirements. “NAHU firmly believes that anyone who is going to be assisting consumers with health insurance options and figuring out tax credits … that person should be trained and held accountable for their actions,” said Jessica Waltman, NAHU's senior vice president for government affairs.
However, despite claims that the legislation is needed to protect consumers, some consumer advocacy groups argue that the laws serve only to inhibit the work of navigators, who will be closely monitored by state and federal regulators.
“Grant agreements with the supervising agency as well as agreements with staff or volunteers serving as navigators should delineate the navigators' duties, how they would be held accountable for their work, and any prohibited activities related to health plan enrollment and counseling related to eligibility for subsidies,” Families USA noted in a white paper on navigators.
The consumer advocacy group backs certification, not licensing, and notes that in some states Medicaid and Children's Health Insurance Plans have entered into agreements with community organizations and other entities to facilitate enrollment.
On April 9, the CMS announced $54 million in grants for organizations and individuals that want to serve as navigators, with the largest awards going to Florida and Texas, the states with the largest number of uninsured residents.
However, regulators have come down on the side of tighter standards. Last month, the National Conference of Insurance Regulators adopted a resolution urging states to enact a licensing framework and regulatory regime for navigators. That drew cheers from agents and brokers, who say licensing is necessary to guard against misconduct, particularly in federally facilitated exchanges.
There is “a huge regulatory void,” said Wesley Bissett, senior counsel for state government affairs at Independent Insurance Agents & Brokers of America, a trade group.
Agents, who can earn commission on selling plans, say they can play a crucial role in helping people enroll. Rick Bailey, a broker who runs his own insurance agency in Woodstock, Ga., agreed that some consumers will go to his firm instead of navigators, who will work mostly in areas that have been underserved by the agent community.
“Navigators are going to be funded with block grants, not a long-term servicing arrangement” that brokers typically operate under, he said.
Brokers will be needed because of the sheer number of people who will be seeking coverage and the specialized knowledge that agents bring to the process possess, said Gary Lauer, CEO of EHealth, which runs eHealthInsurance.com, an online marketplace where people can shop for plans in all 50 states.
“I am personally convinced that in order to achieve getting (tens of millions of people enrolled), getting more ladders into the pool is better than less ladders,” Lauer said.
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