Under Pressure: An Update on Restrictive State Insurance Marketplace Consumer Assistance Laws

Source: Justin Giovannelli, Kevin Lucia, and Sarah Dash, Commonwealth Fund blog, October 31, 2013

To help consumers enroll in the recently opened health insurance marketplaces, the Affordable Care Act created outreach and consumer assistance positions such as “navigators,” in-person assisters, and certified application counselors. Though they are subject to uniform federal standards, in practice, these programs range widely from state to state, because of the adoption of laws and regulations in many states that make it difficult for navigators to perform their jobs, as well as differences in funding for consumer assistance for different types of marketplaces. In this post, the first of a two part-series, we will examine the new restrictions; our next post will look at the how the limited funding for outreach and education for federally facilitated marketplaces, compared with state-run or state partnership marketplaces, may be limiting consumer outreach efforts in those states.

This summer, we reported that many states with federally facilitated marketplaces had imposed requirements more stringent than the federal rules governing the navigator program. Supporters of these efforts say that more regulations are necessary to ensure that navigators are well trained and protective of consumers’ rights. However, some of the new restrictions seem likely to prevent navigators and other consumer assisters from doing the jobs they were created to do.

17 states hinder consumers from getting help in health insurance marketplaces