Could navigator education efforts lead to fraud?


Republican lawmakers are continuing their attack on navigators, who are meant to help consumers when shopping on health insurance exchanges, claiming their education efforts could lead to fraud in the online marketplaces.

GOP members of the House Energy and Commerce Committee want the U.S. Department of Health & Human Services to explain how navigators will describe new health insurance options to consumers, reported The Hill's Healthwatch.

In a letter to HHS, the Republican lawmakers said they're still seeking answers regarding the navigator outreach and education program, including how navigators will actually perform their outreach duties. They're concerned, for example, that navigators going door to door to help consumers sign up for the exchanges could lead to more fraudulent activity.

"The questions and concerns that emerged in our review appear to be a direct result of the rushed implementation of the Navigator program by HHS and the limited time available for training Navigator grant recipient organizations and their staff," the lawmakers wrote.

Another concern for GOP members is that navigators won't be ready by Tuesday to adequately explain health insurance to consumers. Many groups receiving federal grants to train navigators lack health insurance experience and sufficient time to train them, reported NPR Shots.

Rep. Tim Murphy (R-Penn.) also worries navigators will have access to consumers' private information. "It's worth asking what will be done with navigators when they obtain personally identifiable information or health records--names, Social Security numbers, birthday, other information that can be used, and even in some cases, what if people reveal health problems?" he said.

But Democrats have accused Republicans of merely trying to sabotage the program. "The Republicans are on a crusade to stop the Affordable Care Act," Rep. Henry Waxman (D-Calif.) said. "There's been no wrongdoing that anybody can show. It's as if you took a whole bunch of people and said, 'We think you may do something wrong, and now we want to ask you a lot of questions about your organization.'"

To learn more:
- here's the GOP letter (.pdf)
- read The Hill's Healthwatch article
- see the NPR Shots article

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