Teams around the United States are working harder to implement the Patient Protection and Affordable Care Act of 2010 (PPACA) now that the fall elections seem to have increased the odds that the law will stay in effect.
In Minnesota, for example, the Minnesota Health Insurance Exchange Advisory Task Force has been working on matters such as exchange finances, risk adjustment mechanisms, and consumer support.
The consumer support arm of the task force, the Navigator and Agent/Broker Work Group, recently developed a report on recommendations and service levels for the exchange Consumer Assistance/Navigator Program.
Other states seem to be assuming that the people who help consumers use exchange programs will need at least 16 to 24 hours of initial training, the work group said in the report.
The PPACA exchanges
Drafters of PPACA included the exchange provisions in an effort to help consumers and small employers do a better job of shopping for health coverage.
Starting late in 2013, the exchanges, or Web-based health insurance supermarkets, are supposed offer individual consumers, families and small groups menus of standardized, high-quality health plan options. Low-income and moderate-income consumers and some small groups are supposed to be able to use new federal tax credits to pay for the coverage.
Some states are letting the U.S. Department of Health and Human Services (HHS) provide all exchange services for their residents. Other states are building their own exchange programs.
A new type of advisor, the Navigator, is supposed to serve as an ombudsman, or help desk service, for consumers who are trying to figure out how to use the new system to buy coverage. The Navigators can get funding from the exchanges, but they are not supposed to get commissions or other compensation from health insurers.
Health insurance agents and brokers have clashed with regulators, consumer groups and others in some states over whether commercial health insurance producers should be able to serve as Navigators; whether the Navigator staff members who work directly with consumers should be licensed insurance agents or have other types of licenses or certifications; and whether Navigator entities should have to have some version of the errors and omissions liability insurance coverage that commercial health insurance producers have.
Exchange builders also have to confront matter such as the standards Navigator staff members must meet.
