Ellis on TDI’s Proposed Navigator Rules

Health-Gen3

(Austin, TX) // Senator Rodney Ellis (D-Houston) today released the following statement and letter to the Texas Department of Insurance (TDI) regarding TDI’s proposed new rule concerning the regulation of navigators for Health Benefit Exchanges:

“As written, TDI’s proposed navigator rules should not be implemented, as they will impose excessive fees and unnecessary training requirements. While I share TDI’s concern about protecting Texas consumers’ privacy and data, these rules would go well beyond the requirements for others doing similar work. If the impetus for these rules is truly about protecting consumers, then why doesn’t TDI seek to place the same restrictions and requirements on everyone with access to personal information needed for health insurance enrollment?”

“If these onerous restrictions and excessive training requirements are imposed on navigators, TDI should take steps to implement equivalent rules to ensure that consumers are protected regardless of who is providing them with enrollment assistance. Otherwise, these proposed rules appear to be about more than privacy.”

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Letter to TDI Commissioner Rathgeber:

January 6, 2014

Ms. Julia Rathgeber, Commissioner

Texas Department of Insurance

P.O. Box 149104
Austin, TX 78714

Re: Proposed new 28 TAC Chapter 19, Subchapter W, §§19.4001 – 19.4018, concerning Regulation of Navigators for Health Benefit Exchanges, in the December 6, 2013, issue of the Texas Register (38 TexReg 8769).

Dear Commissioner Rathgeber,

I understand that the Texas Department of Insurance (TDI) is moving forward with proposed rules to implement additional restrictions and requirements for navigators.

While I share your concern for the need to protect Texas consumers’ privacy and data, these proposed rules go well beyond the requirements for those doing similar work and singles out navigators.  These proposed rules would impose excessive fees and unnecessary training requirements and put in place restrictions that will prevent navigators from completing their core responsibility of providing consumers with the information they need to make informed decisions about what health plans will be best for them.  These proposed rules go past consumer protection and will hinder Texans from receiving assistance and information about health care options available to them.

As you know, Texas has the highest uninsured rate in the nation and stands to benefit greatly from the implementation of the Affordable Care Act.  One of the key components of the law is the implementation of a health care marketplace, a resource for individuals to shop for and compare quality, affordable health insurance coverage.  For vulnerable and underserved populations, navigators are a critical resource for enrollment assistance.  They are trusted resources for information in their communities and are able to use these connections to inform consumers about health insurance and financial assistance options available through the marketplace.

Furthermore, navigators are only one entity assisting consumers with enrolling in plans; insurance agents and health insurance companies are also helping with enrollment and are exposed to the same private personal data as navigators.  They collect or have access to confidential information including birth dates, social security numbers, and financial information.  While navigators are helping consumers enroll with this information, insurance agents and health insurance companies maintain files with this private personal data.  However, insurance agents and health insurance companies were specifically excluded from the rule making authority in SB 1795, but the need for insurance agents and health insurance companies to be conscientious and accountable when accessing this confidential information still remains.

If the impetus for implementing these new rules is truly about protecting consumer privacy, then why doesn’t TDI seek to place the same restrictions and requirements on all entities that gain access to and maintain files with private personal information necessary for health insurance enrollment? Also, if ensuring all those that have access to such information is a legitimate concern, why have similar restrictions not been proposed in the past?

If these onerous proposed restrictions and training requirements are imposed on navigators, TDI should take steps to implement rules to ensure that personal data is not only protected and secure when in the hands of non-profit and community organizations, but also when in the hand of those who benefit financially from helping consumers like health insurance agents and companies.  TDI should also require that these entities receive the same training as navigators on privacy, ethics, and Texas Medicaid so that they can conscientiously assist Texas consumers with selecting a health plan that meets their needs.

Should equivalent requirements already be in place, please provide information regarding the statutory or rule requirements for health insurance agents and health insurance companies as they relate to registration requirements, background check and finger print requirements, and training requirements including the number of hours devoted to Texas Medicaid, privacy and ethics specifically.

Thank you in advance for considering my comments, and I look forward to your response in writing.  I hope we can continue to work together to ensure consumers are protected and that those who need it have access to affordable health care.

Sincerely,

Rodney Ellis

CC: Sara Waitt, General Counsel, Texas Department of Insurance

Jamie Walker, Associate Commissioner, Licensing Services Section, Texas Department of

Insurance

PDF: Ellis – TDI Navigator Rules Letter

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