Texas Department of Insurance: Lead, follow or get out of the way

RUTH JONES McCLENDON | 2/3/2014, 6:31 a.m.

Texas House of Representatives

The Texas Department of Insurance has adopted agency rules that impede the ability of Texas’ uninsured citizens to sign up for affordable insurance coverage in the health care marketplace. Although there are some improvements in the revised rules, they still impair the ability of the uninsured to sign up for affordable insurance. The effective date will be Feb. 10. The commissioner’s order adopting the rules contains 349 pages; the actual rules begin on page 330. The first 329 pages attempt to justify the rules.

Navigators being regulated by these rules will not have sufficient time to comply with them before the TDI registration deadline on March 1. These rules apply to more persons than the navigator entities that received federal grants under the Affordable Care Act and the individual navigators who report to these entities. The focus of TDI concerns should be on those groups or individuals who do not have any federal ACA certification. TDI should grant provisional registration for certified ACA navigators who present their federal credentials to TDI, and should provide public access to this list of authorized navigators. TDI should let these navigators do what they are authorized to do and help uninsured citizens obtain coverage before March 31.

Eight organizations in Texas received grants to help applicants “navigate” the affordable insurance application: United Way of Metropolitan Tarrant County; Migrant Health Promotion Inc.; National Hispanic Council on Aging; Change Happens; United Way of El Paso County; Southern United Neighborhoods; East Texas Behavioral Healthcare Network; and the National Urban League. These organizations selected more than 44 sub-grantee organizations to help in this effort, and they hired a small number of individual “navigators” to help eligible citizens apply for a health coverage plan. In the Bexar County area, Alamo Area Council of Governments is a sub-grantee of United Way of Metropolitan Tarrant County. ACA navigators have a federal certificate and an identifiable number: the state or a consumer can verify their authorization this way.

The state’s “leadership” chose not to adopt a state health insurance exchange, although that legislation had some bi-partisan support. The rules just adopted by TDI impose requirements on federally trained and certified ACA navigators (and would-be-navigators), which exceed state requirements for community partners working with Medicaid enrollment. Even licensed insurance agents in Texas are not required under current state law or these rules to obtain and pay for the kind of training or fingerprinted background checks that these rules require. Although certified navigator entities may conduct training for individual navigators, they will have only until March 1 to obtain instruction approval from TDI and also provide the training; that is unrealistic.

Here are some points on which I believe we all can agree. Access to early diagnosis and treatment is important to address health problems and keep them from becoming critical or chronic and more expensive to treat.

Affordable insurance is the gateway for that access. Since local taxing jurisdictions are not fully reimbursed for these costs by state or federal programs, the burden on local taxpayers decreases when more patients have health insurance. For the first time ever, many uninsured Texas citizens can now obtain affordable health insurance through one of the Affordable Care Act health insurance options. It is a public disgrace that the Texas Department of Insurance continues to yield to political pressure and create obstacles for uninsured Texas citizens by imposing costly and unnecessary requirements on those who are working to help them. I call upon the department to lead, follow or get out of the way.

Rep. McClendon serves on the House Committee on Appropriations and the House Committee on Transportation. She is the chair of the House Committee on Rules and Resolutions. The 83rd Legislative Session is her ninth term serving the people of Texas House District 120.