GOP proposal would regulate 'navigators' of federal health law

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HARRISBURG -- A Republican-backed proposal to regulate the workers who help customers learn about insurance plans under the federal health care law appears to have traction in a Senate committee.

Pennsylvania would join numerous states in regulating the so-called navigators called for in the federal law. Since 2012, 25 states have enacted restrictions or regulations, according to the National Conference of State Legislatures, which says at least 37 bills have been considered in 22 states this year.

The Pennsylvania proposal, which has been sponsored by more than half the members of the Senate's Republican majority, would require navigators to register with the state Insurance Department and pass a criminal background check. The legislation would allow navigators to provide "general information" about enrolling in a health insurance marketplace but not to compare specific health plans.

At a hearing Wednesday, Sen. Don White, R-Indiana, chairman of the Senate Banking & Insurance Committee and a sponsor of the bill, described it as a "commonsense approach" to ensuring the safety of residents shopping for insurance.

"I believe federal law simply does not place sufficient requirements on navigators, and I think it's important for Pennsylvania to explore options that will protect consumers in the health insurance marketplace," he said.

The legislation would prohibit navigators from selling, soliciting or negotiating insurance, though state Insurance Commissioner Michael Consedine told the panel that navigators already are banned from doing that. In a statement submitted to the committee, he said the Insurance Department "has the authority under existing law" to investigate if someone claims a navigator takes an action that would require a license.

Jack Yanosky, director of the department's Bureau of Licensing and Enforcement, said the agency met with navigators and reviewed which activities would cross the line.

"To date we've had no real issues that have been sent into my bureau whatsoever," Mr. Yanosky said.

The committee's ranking Democrat, Sen. Mike Stack of Philadelphia, said state and federal law provides sufficient safeguards for consumers.

"Under federal regulations, navigators cannot make recommendations to a client on which health insurance they plan to choose, and they must protect the privacy of the person's private financial information," he said.

The Centers for Medicare & Medicaid Services has said navigators do not have access to a customer's information unless the customer asks the navigator to complete their enrollment process, and that navigators cannot access the information once it has been submitted to the insurance marketplace.

Asked if the administration could order background checks, Mr. Consedine noted that constitutional issues have arisen when states approve limits to federal programs. In January, a federal judge blocked enforcement of a Missouri law restricting navigators.

Mr. White said he would like to see the bill addressed by the June 30 state budget deadline.


Karen Langley: klangley@post-gazette.com.

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