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Hearing Highlights Ongoing Debate Over Navigators

As Texas considers additional rules for the workers trained to help uninsured Americans find coverage under the Affordable Care Act, the so-called navigators continue to fuel controversy among critics of the health care law.


RICHARDSON — Members of the U.S. House Oversight and Government Reform Committee met in North Texas on Monday to address the latest controversy surrounding health care "navigators," the workers trained to help uninsured Americans find coverage under the Affordable Care Act.

Before a small but engaged crowd at the Charles W. Eisemann Center, five members of the Texas congressional delegation joined the chairman of the committee, Darrell Issa, R-Calif., to hear testimony on how navigators are certified and overseen in light of new allegations that some have broken program rules and encouraged tax fraud.

Over the past several weeks, Project Veritas, a group led by conservative activist James O’Keefe, has released videos showing navigators at the Urban League of Greater Dallas telling applicants to lie in order to increase subsidies they would receive under the new health law. According to Project Veritas, five navigators have been fired as a result of its investigation. 

U.S. Rep. Pete Sessions, R-Dallas, said he urged Issa to call the field hearing. In his opening remarks, Sessions played a Fox News clip of the hidden-camera footage.

Randy Farris of the Centers for Medicare and Medicaid Services, which oversees the ACA signup process, told the lawmakers that the agency held an online session last week with navigators nationwide to address the events at the Urban League. Farris added that the individuals identified in the videos were all removed from their positions.

Issa and Sessions said they were disappointed that despite weeks of advance notice, Dr. Beverly Mitchell-Brooks, the president and CEO of the Urban League of Greater Dallas, did not appear at the hearing.

Lawmakers also questioned Farris — as well as Kevin Brady, deputy chief of staff at the Texas Department of Insurance, and Carolyn Goodwin, president-elect of the Texas Association of Health Underwriters — about other aspects of the navigator program, like if consumers have a way to verify whether a person claiming to be a navigator is certified.

“We need to hold the administration accountable,” said U.S. Rep. Randy Neugebauer, R-Lubbock. “They say they’re doing some oversight. I want to know exactly what oversight they’re doing, how many site visits, what the audit process is.”

Farris said his staff reserves the right to make unannounced visits to the agency's umbrella organizations — the majority of which are charities — to check on navigators and conduct audits. CMS provides weekly training for navigators on protecting personally identifiable information, he added.

Brady and Goodwin compared the rules for navigators with the higher standards that licensed insurance agents are held to. Agents must carry insurance, pass a state exam, complete continuing education to maintain their license and submit a fingerprint receipt. 

Lawmakers hammered Farris over the fact that the current system lacks a mechanism, like a searchable database, by which consumers could verify the identities of workers claiming to be navigators. No fingerprints, pictures or photocopies of driver’s licenses are taken in the process of validating navigators.

“I’m in the business of trust, but verify and the trust has not been verified,” Issa said.

While the hearing allowed the Republican lawmakers to express their sharp disapproval of the health care law, one Democrat took aim instead at Texas' Republican leadership, which has refused to expand its Medicaid program under the law. 

"I hope we can talk about the more pressing problem of why Gov. Perry is refusing to expand Medicaid,” U.S. Rep Marc Veasey, D-Dallas, said to applause. "I can only imagine it is for purely political reasons."

Others slammed the hearing as a political stunt.

“This hearing is just a dog-and-pony show,” said Brianna Brown, lead health care organizer for the Texas Organizing Project, an organization that helps low-income Texans and promotes grassroots activism. “The ACA is the law, and it’s about time Texas gets on board.”

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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This article originally appeared in The Texas Tribune at http://www.texastribune.org/2013/12/17/oversight-hearing-highlights-aca-navigator-shortco/.

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