By Sam Baker - 05/21/13 04:54 PM EDT
The Health and Human Services Department (HHS) has set aside $54 million in grants to train and pay navigators.
Rep. James Lankford (R-Okla.) said Tuesday that navigators could be "walking away" with an enormous database of healthcare and tax information from the communities where they work.
Congressional Republicans have pressed the administration for records about the navigators program and held a hearing on the subject Tuesday.
Gary Cohen, the director of the HHS office overseeing most of the implementation effort, did not know whether navigators would have to have a high school diploma or the extent to which criminal background checks would be required.
He said navigators would need to demonstrate expertise in health insurance and would take a 20-30 hour online course on the Affordable Care Act — similar to the training for traditional insurance agents.
“That is inadequate, absolutely inadequate," Rep. Paul Gosar (R-Ariz.) said.
Navigators are a key tool for getting people enrolled in new coverage options under the healthcare law.
Although much of the enrollment process will be housed online, navigators are designed to help people who don't have access to the Internet, don't understand the options presented there or simply are more comfortable with in-person assistance.
Rep. Matt Cartwright (D-Pa.) accused Republicans of attacking the navigators program as a way to limit enrollment and further undermine the healthcare law's potential success.
Republicans also questioned whether HHS has the legal authority to fund navigators in certain states. The department's $54 million budget will pay for navigators in the 37 states where the federal government is running all or part of the new insurance exchanges.
Republicans say HHS might be breaking the law by also authorizing a similar program in states running their own exchanges.
HHS has said states can use grants that help establish state-run exchanges to fund "in-person assisters" — similar to navigators, but not technically covered by the same legal standards.
The healthcare law does not allow exchange grants to be used for navigators, and Republicans say HHS is violating that restriction by authorizing a similar program for "assisters."
“You just assume they wrote the bill wrong?” Lankford asked Cohen.
Cohen said HHS will only allow states to use their exchange grants for one year of an "assisters" program.
The grants are intended to help establish an exchange, and explaining new coverage options is part of that task, he said, but anything after the first year — once exchanges are already up and running — would have to come out of state funds.