Healthcare assisters verses navigators

Open enrollment for coverage under the new healthcare marketplaces is set to open in about three month, and opponents of the law are raising new concerns with the plans.

Recently, CQ reported that Republicans in the House of Representatives have questioned the authority of the administration to provide “in-person assisters” in the program. The assistants, separate than the navigators provided for in the law, are also meant to help participants in the exchanges apply for insurance, the National Association of Healthcare Access Management reported.

Gary Cohen, the director of the Center for Consumer Information and Insurance Oversight, acknowledged that an assister was “essentially the same” as a navigator. Navigators are persons that will help customers choose which insurance plan to pick, and they will help determine whether they are eligible for Medicaid or tax credits. Navigators are paid with federal funds, however, and states that are running their own exchanges are barred from federal money. Still, a mandate of all exchanges it to provide outreach, education, and enrollment assistance. This poses an issue for states whose exchanges have not yet become independently viable.

The House Oversight and Government Reform Committee held a joint hearing in May with the subcommittees on Energy Policy, Health Care and Entitlements and on Economic Growth, Job Creation and Regulatory Affairs. After, the chairmen sent a letter to HHS Secretary Kathleen Sebelius expressing concern over the role of the in-person assisters. They stated that they didn’t see any statutory authority for the assister program and that there is no functional difference between the assisters and the navigators.