The latest Obamacare navigator “compromise” may calm one small
battle in Florida. But it won’t end the
war on Obamacare being waged by hypocritical public officials around the
country.
A couple of weeks ago, I wrote about the Congressional
effort to undermine the Obamacare navigation program in its entirety. A House Committee has ordered nonprofits winning
navigation grants to produce reams of material, and promises to punish those
that have failed to comply.
Source: US Census Bureau |
Navigators will assist people in applying for public or
private insurance to pay for their health care.
Navigators are not a new concept, created by Obamacare. They are as old as Marco Rubio, and Obamacare
is not the first federal initiative ever to fund them. In fact, I implemented the policy of the
Nixon Administration as a VISTA paralegal 35 years ago, navigating underinsured
elders to the Medicaid program.
So we know that
navigators can be trusted to do their jobs.
But that hasn’t stopped some public officials from sudden “worries”
that navigators hired by nonprofit agencies will disclose private information
that clients voluntarily give to them.
Three weeks ago, Governor Rick Scott of Florida – apparently
trying to re-establish his credentials as the nation’s leading gubernatorial opponent
of Obamacare after openly flirting with it during the 2013 legislative session –
joined this
chorus, wondering “how the federal government will prevent personal
information from being stolen” by these nonprofits.
This was quite a contrast to enrollment
efforts already well underway in states like Connecticut that actually want
to help people get insured.
Then Governor Scott raised the stakes last week. He ordered that no navigators
be allowed in any state health department offices. The reason this mattered is because in
Florida, county health departments are actually arms of the state government,
and their employees are state, not county, employees.
So in banning the navigators from state offices, he was in
effect banning outside navigators from enrolling people in county safety net
clinics, federally-qualified community health centers, and a host of other
facilities staffed by state employees.
He came under immediate fire from shocked
public health officials, one of whom called the edict “cruel and
irresponsible,” and said that it would compromise access to healthcare for “a
multitude of needy Floridians.” Florida has the second
highest percentage of uninsured people in the nation – two and a half times
the rate of Connecticut.
A day later, state officials backed away after having an Emily Litella moment. They realized that the counties actually own
and control the properties in which the health department clinics operate. The state employees, like the navigators, are
just outside guests in these county buildings.
A compromise
of sorts was struck. The state
acknowledged that it had no authority to keep navigators out of the county
buildings so long as the counties had them work outside of the actual clinic
space.
Now most thoughtful people
with any knowledge of history would probably use a colorful term here to
characterize the state’s position. I’ll
just call it hogwash.
Public officials like Rick Scott are not the least bit worried
about navigators being able to protect the privacy of individuals. How do we
know this?
Because Rick
Scott was CEO of Columbia/HCA until 1997.
Like every hospital chain in the country, HCA hospitals have worked with
navigators for years to capture Medicare, Medicaid, and insurance
reimbursements for uninsured patients. The
navigators are often employees of outside entities working under contract. Many even take a percentage of the billings for
every person they enroll.
I know this because I competed with these companies when I
was overseeing navigation programs for community nonprofits in Texas and
Florida in the 2000s. And these outside companies
had access to all the private information about which Governor Scott professes
to be worried today.
But there is
more.
In Florida, my nonprofit placed navigators in state health
department clinics almost a decade ago and helped capture reimbursements for
the state, relieving taxpayers of the bill.
No one accused us of breaching confidentiality. But Jeb Bush – who had some common sense – was
Governor then, and George Bush was President.
Hypocrisy is always in motion, and tough to pin down. But in this instance, certain public
officials made it too easy for us to see the real reason they want to prevent uninsured
people from getting help paying the bills that clinics and hospitals must, by
law, present to them.
They know for a fact that this part of Obamacare will work,
and they desperately don’t want that to happen.
Paul Gionfriddo via email: gionfriddopaul@gmail.com. Twitter: @pgionfriddo. Facebook: www.facebook.com/paul.gionfriddo. LinkedIn: www.linkedin.com/in/paulgionfriddo/
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