Republicans may have found a new way to undermine Obamacare: By harassing the organizations that are supposed to help people get health insurance.
Last week, Republicans on the House Energy and Commerce Committee sent letters to at least some of the 105 organizations that, earlier this month, received federal grants to serve as “navigators” for Obamacare. Navigators are supposed to help educate people about their insurance options under the new law—by, for example, explaining who is eligible to buy insurance in the new exchanges, or how to use the online marketplaces once they are operating. In some cases, they will actually help people enroll in the new insurance plans. The model for the Navigator program is the State Health Insurance Assistance Program, or SHIP, which has operated successfully for more than 20 years as part of the Medicare program.
The organizations that got federal navigator grants are a mix of non-profit groups and government agencies—everybody from the Missouri Alliance of Area Agencies on Aging to the Utah AIDS Foundation. Planned Parenthood chapters in Iowa, Montana, and New Hampshire are among those getting grants. But so are several religious organizations, including the Oak Hill Missionary Baptist Church Ministries in Mississippi. The organizations that got the five largest grants were all in states with high numbers of uninsured people—Texas, Florida, Georgia, Ohio, and Michigan. (The Centers for Medicare and Medicaid Services has a full list of the organizations, and Phil Galewitz of Kaiser Health News has more background on them, if you want more information.)
With the new insurance marketplaces set to open in exactly four weeks, these organizations are scrambling to get ready in time. But now, thanks to the House Republicans, they’re also scrambling to answer a committee request for information. “In order to better understand the work you will perform,” the letter states, the Committee is asking the organizations to schedule a briefing “to occur no later than September 13”—and to answer six lengthy questions about their operations.
There’s absolutely nothing wrong with a congressional committee performing its oversight role, particularly when it comes to a law as complex as the Affordable Care Act. And the navigators deserve at least some scrutiny. Do they have all the training and information necessary to give people the right advice? Can they be trusted with personal information? Even a few of the law's defenders—most conspicuously, California Insurance Commissioner Dave Jones—are asking those questions. House Republicans have a right to ask them too.
But the committee questions cover much more than training and security. And complying with the request will be no small thing for these organizations to do. Here’s the sixth item, just to give you a sense of how much information the committee is seeking:
Provide all documentation and communications to related to your Navigator grant. This would include, but is not limited to, materials your organization submitted in order to obtain the grant, materials provided to your organization upon obtaining the grant, and communications between your organization and representatives from HHS, CMS, CCIIO [the Center for Consumer Information and Insurance Oversight] or any other federal or state entity. This request also includes, but is not limited to, any documents provided by (or communications with), representatives from HHS, CMS, CCIIO, Enroll America, or any other entity including federal or state governments discussing individuals to target or solicit for enrollment under the PPACA including discussions or documents related to geographic area.
The letter and five-page guide for responding to committee requests are below if you want to see them for yourself. To people like Timothy Jost, the law professor at Washington and Lee and longtime proponent of reform, such a broad and detailed inquiry reeks of bad faith. Via e-mail, he told me:
Look at item 6 and the accompanying sheet defining documents subject to the request. This could include hundreds of documents and emails and could take days to locate and compile. It might have been reasonable to ask them to describe what they do and how they intend to do it. This is a much more intrusive and extensive request. It is also important to note that most of these organizations are doing this on a comparative shoestring, and this is the busiest time in their existence. They just got their grants, they are concluding cooperative agreements with HHS, they are hiring, training their employees, getting them certified, setting up security systems, making contacts, and even to have to take a day off to respond to this is too much. And the committee knows this. This is not about gathering information. It is about trying to stop a program.
Norm Ornstein, the political scientist at the American Enterprise Institute, had a similar reaction when he saw the request:
Requests for documents is not unprecedented; the Oversight and Investigations Subcommittee of Energy and Commerce did it all the time under Democrats. But this is qualitatively different. The scope and the timing simply smell. Oversight would commonly mean that after a program has been implemented you look to see if it was done well and if there was fraud or malfeasance or misfeasance. This is intimidation and another effort at sabotage.
Committee spokepersons didn't respond to media requests over the weekend. If they do, I'll update this item. But keep in mind that the navigators' primary job is to boost enrollment in Obamacare, a goal Republicans and their allies have made clear they don't share. On the contrary, Republicans and conservatives have actually tried to stymie or at least limit enrollment—by warning professional sports leagues not to promote the new insurance options, for example, and encouraging young people not to sign up. (Sandhya Somashekhar documented some of the latest efforts, at the state level, in the Washington Post last week.) And while sometimes these efforts are subtle, sometimes they aren't. During a recent, Ralph Hudgens, the state insurance commissioner of Georgia, told his fellow Republicans how he and his counterparts in Georgia's state government were treating Obamacare. "Let me tell what we’re doing,” Hudgens said. “Everything in our power to be an obstructionist.”
Is it possible House Republicans are simply performing due diligence, in order to make sure people who need Obamacare's help can get it? Sure. But it doesn't seem very likely.
Jonathan Cohn is a senior editor of the New Republic. Follow him on twitter @CitizenCohn