Unfortunately this was another week of not much progress on our priority issues. The Iowa House still has not taken up the Health & Human Services appropriations bill, so now it looks like the Senate will move a bill first next week. The good news in this development is that the Senate bill contains $5.3 million for tobacco prevention and cessation programs compared to $0 in the House bill and $2.8 million this year.
The Iowa House passed a bill this week that usually gets little attention - the annual Insurance Division bill, made up of changes to the law that the state Insurance Commissioner recommends. This year a number of amendments to the bill made it controversial. One, dealing with navigators in the health insurance Exchange (which has not yet been established by the Legislature), is of particular concern to us.
This amendment is plainly bad public policy, and here`s why:
- It creates the potential to raise the cost of the navigators, thereby resulting in higher than necessary consumer out-of-pocket or premium costs.
- The new federal regulations allow the states to set up a licensure process for navigators, but the process in this amendment would be very similar to that of insurance agents and brokers, essentially making them de facto agents and brokers.
- The licensure process, fees and bond requirements in the amendment, none of which are required by federal law, will be a barrier for nonprofit organizations and individuals other than agents and brokers who may want to become navigators.
- The core function of the navigators is supposed to be to help consumers understand the range of options for which they are eligible within the Exchange, including public programs like Medicaid and S-CHIP. Navigators are also required to offer assistance with the tax credits available for anyone with an income below 400 percent of the federal poverty level. There is no mention in the amendment of these duties, nor the training required to carry them out.
- The amendment is an unnecessary, backdoor way of tying the hands of an Exchange in Iowa without creating a state Exchange. The Exchange is the entity that has the obligation to establish the navigator system, train them, contract with them, and fund them.
- If this amendment becomes law, Iowa would be the first and only state to create a navigator licensure provision without having first established an Exchange.
In summary, this amendment could result in higher health insurance premiums, limit access to free navigator services, and potentially violate federal law. There is no question that it violates the principles agreed to by the Iowa Health Advocates, a coalition of patient and consumer groups of which the Cancer Society is a part.
We will be working to get this objectionable amendment removed from the bill or add language to make it more advantageous for patients and consumers. Stay tuned for an Action Alert early next week.
As always, feel free to contact me directly with any questions or concerns - peggy.huppert@cancer.org.
