Lawmakers air privacy concerns about insurance-exchange navigators

The chairmen of two House Ways and Means subcommittees this week pressed HHS Secretary Kathleen Sebelius to address privacy concerns regarding workers who will help consumers buy health coverage through state insurance exchanges.

In a letter to Sebelius, Rep. Charles Boustany Jr. (R-La.), chairman of the Oversight subcommittee, and Rep. Kevin Brady (R-Texas), who heads the Health subcommittee, noted that the thousands of navigators who will assist consumers “will have access to sensitive taxpayer information.”

They asked whether navigators and other assisters will have access to Social Security numbers, birthdates and income data. They also asked if anything within a proposed rule issued on April 3 would prohibit convicted felons or those who are paid by labor unions or political organizations from serving as navigators.

The lawmakers want to know what materials will be used for training navigators and whether training on privacy issues is planned. They also asked: “To what extent has Department planning contemplated non-government sources of funding to support navigator organizations?”

Though the navigator program, among other aspects of the healthcare reform law, has come under attack by Republicans, health policy observers were split over whether politics are behind the letter.

“Who are these people?” asked Robert Laszewski, a former insurance executive and president of Health Policy and Strategy Associates, a consulting firm. “Have background checks been done? How are the paper forms they are filling out—that have all critical identity info—being safeguarded? How safe will the computer systems in the 17 (state-run exchanges) and the 33 federal exchanges be safeguarded?”

Laszewski added, “These navigators are people recruited—there will be hundreds of thousands of these people across the country—to do the work for perhaps $50 per application. This will be a huge quality-control issue.”

Jennifer Kowalski, a vice president in the health reform practice at Avalere Health, a Washington-based consulting firm, said there are some legitimate concerns not in the letter that HHS has yet to address regarding navigators, such as the role of providers and federally qualified health centers in offering consumer assistance with exchange enrollment.

The National Association of Health Underwriters, the trade group for brokers and agents, has urged additional training and certification for navigators.

Follow Jonathan Block on Twitter: @MHjblock