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Exchanges and Navigators

By April 5, 2013Commentary

It is probably not good when something has gotten so complex that people are presumed to need a “navigator” to deal with it, but that is apparently where our health system has landed.  And of course once you have managed to make the whole system that complex, you will of course need a lot of pages of  rules to govern how those navigators will function.  And of course, none of this complexity and regulation will add one dime to the overall cost of health insurance and health care in the United States!   So without further ado, here is the new Health and Human Services regulation on navigators.  (HHS Rule)   The insurance exchanges are supposed to provide individuals and small businesses the opportunity to shop among a variety of health plans and promote competition.  (Of course, HHS has already said that next year they won’t be able to offer more than one option for small businesses using the federally run exchanges, so much for choice and competition there!)  But being presented with a lot of choices can actually make things harder for many consumers and comparing health plans isn’t always easy.  Private exchanges already typically have a variety of tools to help consumers make comparisons and select the plan which might best fit their needs and presumably the new exchanges will as well.  Navigators are designed to be a backup option of a real, live person who can help consumers get through the eligibility and enrollment processes involved in an exchange and to ensure that they have and understand the information needed to make choices.  The rule basically sets out information about funding navigator programs, the qualifications of navigators, avoiding conflicts of interest, etc.  Basically a waste of paper and bytes, but don’t despair, yet more rules are coming on other categories of helpers, like an application assistance counselor!

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