On Monday, the Joint Committee on Agency Rule Review approved rules proposed by the Ohio Department of Insurance to exempt government agencies, food banks, federally qualified health clinics and hospitals from certification requirements for “navigators,” the groups or individuals who will assist consumers seeking to enroll in the new health exchange.
Advocates for the program rightly are concerned that the rules do not specifically exempt others, say, faith- and community-based organizations. Such groups may fear facing penalties, and thus back away from continuing services to consumers navigating the new health care landscape.
Estimates are that some 524,000 Ohioans will be eligible to participate in the new state health exchange, an online marketplace that will offer a variety of health plans from competing insurers. The period for enrollment in the exchanges opens Oct. 1. But few of those who most need to know about the opportunity are aware of it. In June, a national tracking poll by the Kaiser Family Foundation found that a mere 12 percent of the uninsured said they had heard “some” about the exchanges. Thus, there is no overstating the need for an extensive outreach and information campaign.
The challenge to inform all those who will need help is formidable. The least the Department of Insurance can do is encourage as many groups as are capable to help raise awareness and ease the confusion inevitable with such a major change. Especially because state leaders refuse to support with state funds the outreach and education effort of navigators, it is essential that the department not put rules in place limiting the capacity of local organizations that do offer assistance with health care as part of their services.
Ohio’s leaders chose to let the federal government create the state health exchange. They opted to certify the navigators and regulate what they can do — with penalties if individuals or groups violate the rules. They also chose to certify only individuals or groups that are funded from the $2.2 million Ohio will receive in federal funds for the purpose. At that funding level, advocates estimate the state will be able to hire 60 to 70 navigators, fewer than one per county.
The concern is that a church or community group that holds periodic health fairs, offering screenings, reviewing eligibility options and guiding consumers, may withhold such help regarding the exchange for fear of violating the law. State officials insist groups that are not specifically exempted by the rules need not worry if they do not put themselves out as navigators. Fine. But an exemption in writing would be more reassuring.
Correction: As originally published, this editorial erred in describing the amount of federal money available for navigators to help individuals or groups seeking to enroll in the new health insurance exchange. The editorial now reflects the correction.