September 8, 2013; Charleston Daily Mail


To give the man his due, West Virginia Attorney General Patrick Morrisey has issued a statement justifying his letter to West Virginia Patent and Training Information, one of the state’s two designated navigators for the new healthcare exchanges, which some—including Senator Jay Rockefeller (D-WV)—allege was simply to intimidate the nonprofit and scare it out of the program. As it turned out, WVPTI decided to turn down the grant it had applied for from the Department of Health and Human Services due to “unforeseen circumstances,” some of which might have been a letter with 26 questions from the state’s top legal officer.

Try Morrisey’s explanation on for size and see if you think he was simply asking questions to help the nonprofit navigator function better. “President Obama and Senator Rockefeller have joined together from the beginning to push Obamacare on West Virginians,” Morrisey said in a statement. “Now, they expect consumers to blindly sit by and trust their rushed implementation efforts.”

The AG’s visceral hostility to the Affordable Care Act, the formal name for the program Morrisey called “Obamacare,” is not difficult to discern. Already on record in favor of repealing the ACA, Morrisey vented more in his statement, including Senator Rockefeller in his pique:

“Why is Senator Rockefeller so convinced that these Obamacare navigators—many of whom are seasonal workers, without a background in health insurance—will understand thousands and thousands of pages of regulations in a few weeks after only 20 mandatory hours of online training? Why move forward with this navigator program before it is fully vetted? How will the public know the difference between an Obamacare navigator and a scammer?”

While there doesn’t appear to be a drop of anything other than opposition to the ACA behind Morrisey’s letter, there are real concerns about the navigator program that could and should be reviewed by a congressional committee asking questions—not of the beleaguered nonprofit navigators, but of HHS. The navigator grants were only awarded in mid-August and the training materials for the people to be hired to serve as navigators only a few days ago. The House committee chaired by Rep. Fred Upton (R-MI), which has sent letters to more than 50 of the navigator grant recipients with requests for documentation that sound just as intimidation-focused as the letters sent by 13 state AGs (all Republicans), would be more defensible if it were asking HHS what took it so long to get the navigator grants announced and the training materials disseminated for people who are supposed to be functioning as of the October 1st startup date of the exchanges, with coverage beginning January 1, 2014.

If the navigators operate as they should, it will be hugely important—not only to the success of the Affordable Care Act, but to the ability of uninsured people, perhaps half of the 30 million or so uninsured in the nation, to finally get health insurance coverage. Rather than relying on hope that consumers will know where to go for assistance or be willing to line up at a government agency akin to the DMV, the navigators will be going to where the uninsured may be found, to reach out to them and help them get the assistance they need. According to Carla Johnson, writing for the Associated Press:

“The guides (a.k.a. navigators) will be sent to community events with laptops to help people sign up for insurance online. They will work at food banks, shelters, churches and free clinics where the uninsured are likely to be…The navigators must listen to a family’s real-world story, assess its income, and figure out eligibility for the Medicaid program, which provides health care for the poor, or for new tax credits, each with its own complicated rules.”

It is truly exciting to see a program designed to reach out to provide people with help, rather than assisting only those who can find their way through a bureaucratic maze. For these groups, the AGs’ letter and the letter from the House Committee on Energy and Commerce—the latter with a September 13th reply date—are nothing more than obstacles in the path of the groups trying to develop fully operational programs by October 1st. Referring to the House committee letter, Tara McCollum Plese of the Arizona Alliance for Community Health Centers seemed nonplussed. “This request threw us for a loop, quite honestly,” Plese said. “We haven’t even drawn down any funds from the grant.”

Given that House Republicans under Majority Leader Eric Cantor (R-VA) just announced their latest approach for defunding the Affordable Care Act in the run-up to the Continuing Resolution, there is little to guess about the unfortunately nefarious motivations of the ACA letter writers.—Rick Cohen