Issa: HHS Improperly Funding Exchange ‘Assisters’ Program
In a letter sent Thursday to HHS Secretary Kathleen Sebelius, Rep. Darrel Issa (R-Calif.) accused the department of "intentionally circumvent[ing] an explicit federal funding ban" to help states establish programs that will help consumers enroll in the Affordable Care Act's insurance exchanges, The Hill's "Healthwatch" reports (Baker, "Healthwatch," The Hill, 6/13).
Under the ACA, exchanges that will be operated solely or in partnership with the federal government are expected to have two certified navigators, one of which must be a not-for-profit.
The navigators must provide "fair, impartial and accurate information that assists consumers with submitting the eligibility application, clarifying distinctions among [qualified health plans] and helping qualified individuals make informed decisions during the health plan selection process." They also must provide additional assistance to consumers with disabilities, limited proficiency in English or who are unfamiliar with health insurance.
Issa -- chair of the House Oversight and Government Reform Committee -- and other House Republican leaders in recent months have stepped up their scrutiny of the navigators program and a separate "in-person assisters" program in states that will operate their own exchanges.
HHS has allocated $54 million in funding grants to train and pay navigators in the 37 states with federally run exchanges. The ACA prohibits such grants for the assisters program because it does not have to meet the same criteria as the navigators program (California Healthline, 5/22).
Details of Issa's Letter
In his letter to Sebelius, Issa said he had received conflicting responses from two HHS officials about the use of the grant money for the navigators and assisters programs.
He said one official told him that the funding is legitimate because assisters are different from navigators and therefore are not subject to the same restrictions.
Issa added that HHS has disobeyed the funding ban "in the interest of convenience and political expediency."