The Ohio House of Representatives has passed a bill setting training and certification requirements for a new group of professionals who will help guide consumers through the new health insurance exchange.
The so-called health navigators, who may work for community groups, for example, will help educate consumers and small businesses about the new online markets created by the federal health care law. Through these online exchanges, consumers will be able to buy individual private policies and apply for government subsidies to help pay their premiums.
The exchanges open for business Jan. 1, 2014, but open enrollment for insurance plans begins Oct. 1 of next year.
Ohio’s bill requires navigators to pass criminal background checks and specifies what navigators cannot do, such as sell, solicit or negotiate health insurance. Rep. Barbara Sears, the bill’s sponsor, says the measure would serve as a blueprint as the state moves forward to meet the federal requirements.
The bill cleared a legislative committee on Dec. 5 before the full Ohio House passed it on a 56-32 vote. The measure now heads to the Senate, where it will be shuffled into the flurry of last-minute, lame-duck session action.
The state Department of Insurance supports the proposed regulations.
Ohio has opted for a partnership with the federal government to run the exchange but doesn’t intend to run its own navigator program. An official with the insurance department told lawmakers Ohio can regulate navigators without running its own program.
“Running the navigator program and regulating those participating in it could create a difficult, if not inappropriate, relationship,” said Michael Farley, department assistant director for legislative affairs.
Farley said the bill would protect consumers and give those who wish to have navigator programs the information needed to hire and train the health care guides.
Consumer advocates agree that navigators should be regulated, but say the bill is flawed.
Nita Carter of the Universal Health Care Action Network of Ohio said the measure needs to be flexible enough to allow navigators to help people enroll in the exchange.
“We’re going to have navigators in our communities and people’s homes, and they might not be able to just stop the process and go find a broker or an insurance agent,” said Carter, the group’s health equity director. “We just don’t want it that restrictive.”
Carter’s group would like to see a clearer picture on the role of navigators.
“So this is the beginning, but this doesn’t even begin to get us where we need to go,” she said.