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Texas Sets Up Roadblock For Health Care Navigators


Although the Affordable Care Act is the law of the land, there are ongoing fights in many states over how to carry it out. One conflict concerns navigators, the insurance counselors who are supposed to help people learn about the law. This week saw two major developments: a federal judge put a strict Missouri law on hold, saying the state didn't have the right to regulate the work of navigators. But in Texas, state officials did just that this week.

Carrie Feibel of member station KUHF in Houston reports on the new rules in Texas.

CARRIE FEIBEL, BYLINE: Navigators are the foot soldiers of the Affordable Care Act. They go to health fairs, libraries, community centers, anywhere they might find people who need help signing up.

CEDRIC ANTHONY: I'm seeing a really big demand. A lot of people are kind of bamboozled. They don't know which way to go.

FEIBEL: That's Cedric Anthony, a navigator in Houston. This week, he learned he'll have to take 20 more hours of state-mandated training on top of roughly 25 hours he's already completed for the federal government. The new rules also mean he'll have to register with the state, undergo a background check and get fingerprinted. Anthony worries the extra steps will distract navigators at a crucial time. As in other states, enrollment on HealthCare.gov has been slower than expected. This year's deadline is March 31st.

ANTHONY: I just feel that it's just going to be more hours in the classroom actually learning instead of the hours we could be putting manpower on the streets getting people signed up.

FEIBEL: But Texas officials say the new regulations will protect consumers because signing up involves sensitive data like Social Security numbers and income. Julia Rathgeber is the Texas Insurance Commissioner. She issued this recorded statement after the rules came out this week.

JULIA RATHGEBER: These rules will give Texans confidence that navigators have passed background checks and received the training they need to safeguard consumers' personal information.

FEIBEL: Texas Senator John Cornyn also praised the rules, saying, quote, "Obamacare presents enough problems for Texans without the risk of a convicted felon handling their personal information." But Orell Fitzsimmons dismisses the idea that navigators are untrustworthy. He's the field director for United Labor Unions Local 100, which employs 17 navigators in Texas.

ORELL FITZSIMMONS: We've been doing this for three months now and we know all the ins and outs better than anyone else in this city. So if they want to challenge us, that's fine. If they want fingerprints, they can have them. We're not hiding anything.

FEIBEL: Obamacare supporters say the regulations are merely political roadblocks preventing navigators from doing their jobs. Congresswoman Sheila Jackson Lee of Houston says Texas should stay out of it.

REPRESENTATIVE SHEILA JACKSON LEE: It's a federal program. The state has no right to interfere with burdensome regulations. It's almost similar to blocking someone from the right to vote because of the color of their skin. Now, you're blocking a sick person or a person that is uninsured from getting access to the information.

FEIBEL: Texas has somewhere between four and 500 navigators. Orell Fitzsimmons of the labor union has only a few weeks to get his navigators registered and fingerprinted. And he also has to find money to pay for the new training. But overall, he's optimistic.

FITZSIMMONS: In the next open enrollment period, which starts October 15th, we're going to get swarmed by people. So it's the first taste, it's not the last taste. And it's going to be successful. In the long run, people are going to remember who was against this and they're going to remember who was for this.

FEIBEL: Texas is one of 17 states that have passed laws restricting navigators. Tennessee and Missouri have both been sued over the issue and their navigator laws are now tied up in the courts. For NPR News, I'm Carrie Feibel in Houston.

BLOCK: This story is part of a collaboration of NPR, KUHF and Kaiser Health News. Transcript provided by NPR, Copyright NPR.

Carrie Feibel is a senior editor on NPR's Science Desk, focusing on health care. She runs the NPR side of a joint reporting partnership with Kaiser Health News, which includes 30 journalists based at public radio stations across the country.

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