Concerned or just Cunning? G.O.P. Interference With Obamacare

Posted on Sep 16, 2013 by Ailee Slater (G+)

In the more than three years since the passage of Obamacare in March, 2010, U.S. Republicans have found a number of ways to express their displeasure with the health care bill. Republican senators have nearly 40 times tried to repeal or delay the Affordable Care Act, and in state-level government, many Republican governors have refused to take federal money and expand their Medicaid programs. Last month, when a group of G.O.P. lawmakers issued a series of congressional requests to groups receiving grants under Obamacare, small surprise that these senators were accused of abusing their authority to further impede the Affordable Care Act.

The federal grants in question are known as navigator grants, and they have been given to universities, hospitals, food banks and other community organizations that are currently doing outreach work to get state residents informed about purchasing insurance under the new Obamacare system. The navigator grants will help these groups hire or train employees (or “navigators”) who can advise clients about what policies are available and how to make the best health insurance choice. Online insurance marketplaces open in every state on the 1st of October, at which point residents without insurance may need the assistance of navigators to understand how to use their state’s insurance exchange.

In July, $150 million in navigator grants was given to groups in 34 states, and in August, the federal government distributed another $67 million to those same groups. Lawmakers both Republican and Democrat have admitted that the federal money given was more than expected, which is perhaps why a group of Republican senators on the Energy and Commerce Committee decided that with such a large federal expenditure, more oversight was necessary. On August 26, those Republicans issued a letter to 51 of the grant-receiving organizations, requesting a variety of documentation regarding their navigator grants.

The letters asked that each group submit: a written description of how many people the organization had employed or hired on as a volunteer, and a record of each of these people’s pay and duties; a written description of how employees or volunteers hired with grant money are being trained in their duties, and copies of any current or future training materials; a written description of processes in place to monitor navigators, and copies of documentation related to monitoring standards; a written description of measures the organization is or will be taking to keep clients’ private information secure, and a description of whether or not information gathered from clients will be used by the organization at a later date to contact clients; a written description of whether or not any insurance companies have been in contact with the organization about use of the navigator grant; and copies of all documentation related to the organization’s receiving of the grant, including but not limited to materials which were submitted to get the grant in the first place, communication with any federal or state group about the grant, and materials received upon being approved for the grant.

Clearly, these G.O.P. senators are asking for a great deal of information and a huge number of documents. Organizations that have received navigator grants have been very vocal in their criticism of these Republican requests, and many lawmakers and other advocates in the health care industry have joined in with complaints that these Energy and Commerce Committee senators are abusing their authority in order to hamper the effectiveness of upcoming state exchanges and the success of Obamacare in general.

The Ohio Association of Foodbanks is one example of an organization that was approved to receive navigator grant money, and has since been faced with meeting G.O.P. requests for information and documentation. Lisa Hamler-Fugitt, director of the Association of Foodbanks, called the requests “offensive” and “shocking,” adding that for organizations to meet the demands of the Energy and Commerce Committee, groups like hers will be forced to stop their current work and devote a huge amount of staff time toward gathering the necessary paperwork. What’s more, Hamler-Fugitt notes that the Association of Foodbanks, like other groups receiving navigator grants, has not yet begun to use the grant money, and therefore documents on employee salary and privacy policy do not yet exist and cannot possibly be provided to these senators.

At the Washington and Lee University School of Law, Professor Timothy Jost has criticized the letters, calling them a transparent attempt by Republicans to intimidate and bully groups using a navigator program. Jost points out that many of these groups are non-profit, and therefore do not have the resources to legally fight the G.O.P. requests, but equally do not have the money with which to meet those requests. Lee joins Democratic senator Henry Waxman of California, Erin Shields Britt of the Department of Health and Human Services, and many more high profile spokespeople in this criticism of the letters.

The date of the Energy and Commerce Committee letters is also conspicuous – drafted on the 29th of August, the letters require that all requested documentation be submitted by the 13th of September. Not only is this a very short amount of time in which to ask an organization to provide such a large amount of paperwork, but additionally, these groups are already extremely busy preparing for the opening of insurance exchanges on the 1st of October. To take employee power away from outreach work will mean less information and support for state residents, many of whom are uninsured and in need of help understanding and using the new insurance marketplaces.

On the other side, Republicans are arguing that they need the requested documents in order to prevent grant-receiving organizations from committing privacy violations. Republicans have previously been quite vocal in their criticism of navigator programs, saying that when organizations conduct outreach to help state residents purchase insurance, they are taking business away from insurance brokers. With the request that groups provide documentation of their commitment to privacy and not contacting clients at a later date, it seems Republicans might also fear that navigation programs could misuse client information to conduct voter canvassing in the future.

At the moment, no action has been taken to overhaul the G.O.P. requests, however the Obama administration did last week describe the letter as a “blatant and shameful attempt to intimidate.” But, at this point, grant-receiving groups which have been sent the request letter have little choice – with insurance exchanges opening in less than a month, they must use all time and resources necessary to comply with the Energy and Commerce Committee demands.