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Ohio House Passes Bill To Regulate New Health Insurance Navigators

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The Ohio House has passed a bill that would provide authority to the state to regulate navigators-the people who, under the new federal health care act, would help direct people without insurance to insurance providers. But as Ohio Public Radio’s Jo Ingles reports, there are some questions about whether the state can do that.

Thursday, December 6, 2012 at 5:25 pm

Ohio is not setting up its own health care exchange and will let the federal government do it for the state. And Republican State Representative Barbara Sears says the state is not doing a specific partnership with the federal health care plan. She says her bill, which was passed by the house, speaks only to the issue of regulating navigators the people tasked with helping uninsured Ohioans find coverage.

Sears: “This legislation does not violate the intent nor the spirit of the health care freedom constitutional amendment passed overwhelmingly by Ohioans. This legislation provides the department of insurance specific authority to regulate agents and navigators. It holds navigators to many of the same consumer protections that Ohioans have demanded for years from its agents.”

Sears says this is the first step in the state declaring authority as it relates to navigators and the exchange. And Sears says it’s the only step Ohio should take at this point. But Democratic State Representative John Carney says the legislation doesn’t go far enough to be effective. He says in order for the provision to work, the state needs to be part of the federal health care program.

Carney: “This is only a very small piece of the mechanism we need to put in place for people to obtain health insurance. The navigation function is literally the people out there who are giving advice to individuals who need health insurance and directing them to products in the exchange that they need. Unfortunately, we have yet to create the underlying health insurance exchange that will have the insurance products that these navigators will be selling to Ohioans. So I would argue that this legislation is premature.”

But Majority Republicans who control the Ohio house rejected an amendment Carney proposed that would have helped the state get into an exchange. Cathy Levine with Ohio Consumers for Health Coverage says all of this is leaving her wondering what’s really going on right now.

Levine: “I don’t know why the sudden sense of urgency on this bill. It regulates the navigators for the health exchange even though Ohio has said it’s not going to operate the exchange or the navigator program. So I don’t understand why they are in such a rush to pass regulations for navigators if they are not going to operate the exchange or the navigator program.”

Levine and some others who are interested in this issue wanted to testify about this bill when the house was considering it but didn’t get that opportunity. She says she has a lot of legal questions about it and suspects it will run into legal trouble if the senate passes it and the Governor signs it-in its current form.

Levine: “Our recommendation is that when they file a blueprint in February that they operate the navigator program and then have an open stakeholder process to talk about what the qualifications of navigators are what populations need navigators.”

Levine says if this bill is to guarantee insurance brokers still get money for selling their products, there’s no need to worry. She notes insurance brokers who currently profit by selling their products to consumers should still have that opportunity since many of the people who will likely need navigators are those who have never had insurance before. And she says it’s possible that once those navigators explain the process and products available, those Ohioans will go to the insurance brokers to enroll in coverage.

But backers of this bill say it is to protect consumers. They note the department of insurance currently regulates insurance agents and as navigators are established in state law it is important to extend that same standard to their new role in the insurance marketplace. The bill now goes to the Ohio Senate.

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