Medicaid enrollment firm gives up on navigator program

September 16, 2013 at 09:59 AM
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FORT LAUDERDALE, Fla. (AP) — A company that has for decades helped people enroll in Medicaid says it won't be able to sign up people for insurance under the new Affordable Care Act because there is too much scrutiny over a so-called navigator program.

According to an email obtained by The Associated Press, Cardon Outreach's chief legal officer Charles Kable told the federal government it was returning more than $800,000 in federal grant money. The funds were supposed to be used to hire people in four states help explain the intricacies of health insurance to millions of people who aren't covered.

While the email didn't go into specifics, some have said those opposed to the health care law, mostly Republicans, are making it difficult for some of the navigator programs to get off the ground.

"The emerging state and federal regulatory scrutiny surrounding the Navigator program requires us to allocate resources which we cannot spare and will distract us from fulfilling our obligations to our clients," the email said.

Texas-based Cardon Outreach was one of more than 100 nonprofits and related organizations recruited by the federal government to sign up navigators to help the 30 million uninsured people who can now gain coverage. The federal government gave the groups more than $67 million grants.

Cardon Outreach was supposed to help people in Florida, Oklahoma, Utah and Pennsylvania. The company, which has done similar outreach for 20 years for Medicaid recipients, did not return emails and phone calls.

Navigators are getting caught in the political crosshairs of the new health care law as the Oct. 1 launch date for the online state exchanges, a key component of the law, draws closer.

Cardon's decision comes days after Florida health officials, which fall under Republican Gov. Rick Scott's administration, ordered county health departments across the state to ban navigators from their property. Democrats lambasted the move, saying it put politics ahead of people.

Scott's office has said only that he was aware of the decision.

Wisconsin and Indiana, both states led by Republican governors, are asking navigators and volunteers to pay fees for training. Some states are also charging for background checks.

Supporters of the new law said they expect even more efforts to derail it.

"It reaches the height of absurdity when someone who truly is a volunteer is going to have to pay a fee to provide that advice," said Ron Pollack, executive director of the liberal advocacy group Families USA.

In addition, Republicans on the U.S. House Committee on Energy and Commerce have called on some of the grant recipients to answer questions about their budgets, training and supervision. The Republicans' letter set a deadline last Friday for dozens of groups to produce documents.

Rep. Henry Waxman, the top Democrat on the committee, said the request was voluminous, time-consuming and particularly suspect.

"It appears that these requests may have been sent solely to divert the resources of small, local community groups just as they are needed to help with the new health care law," he said in a letter to the committee chair.

But Republican Rep. Diane Black and several other lawmakers have warned the navigator program is ripe for fraud and abuse because the counselors will have access to personal information, including an applicant's income and immigration status. Critics have also questioned the security of the database where the information will be stored.

Federal health officials have repeatedly said applicant information is not stored in a database, but is instead transferred instantaneously through a secure hub.

For years, the Medicare program has relied on trained counselors to help seniors sort through various plans, yet Medicare counselors never faced this kind of scrutiny from Congress, federal health officials said.

"It is shameful and unprecedented for Congress to bully and intimidate private organizations that have legitimately received federal grant money to do nothing more than help people enroll in health coverage," HHS spokeswoman Joanne Peters said. "This is clearly an ideologically driven attempt to prevent the uninsured from gaining health coverage."

Federal health officials stressed that despite the hurdles, they will be ready Oct. 1, and there will be plenty of other ways to access coverage apart from navigators.

People can go online or call a hotline. Agents and brokers, providers from community health care centers and church groups and non-profits will be available for face-to-face conversations.

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