Texas Sen. John Cornyn (R) grilled Health and Human Services Secretary Kathleen Sebelius about the Affordable Care Act’s ‘Navigator’ program during a Congressional oversight hearing on Wednesday, suggesting that the health care law would grant convicted felons access to sensitive medical information and jeopardize Americans’ privacy.
“The president is in Dallas, Texas today touting the navigator program, which as you know are people who are hired to navigate the [Affordable Care Act], but I would just like to ask you this question,” Cornyn said to Sebelius. “Isn’t it true that there is no federal requirement for a navigator to undergo a criminal background check, even though they will receive sensitive personal information for people they help sign up for the Affordable Care Act?”
Sebelius responded that while the federal government does not require recipients of the so-called Navigator grants to conduct background checks on their employees, “states can add an additional background check and other features.”
Indeed, several states — including Cornyn’s Texas — have either enacted or are considering additional privacy protections, though the new mandates could actually complicate Navigators’ efforts to sign up low-income uninsured Americans in health care coverage.
Federal rules already require Navigators to receive 20 hours of training, including instruction in client privacy, and impose fines of up to $25,000 for violations of confidentiality. Grant recipients must also abide by 45 C.F.R. § 155.260, “the statutory provisions providing for the privacy and security of personally identifiable information under the Affordable Care Act” and many organizations perform additional privacy trainings for their employees.
Recipients of the grants are typically experienced and trusted community centers, that have a long history of helping seniors or children enroll in government programs like Medicare, Medicaid and the Children’s Health Insurance Program without incident. A state like Texas currently doesn’t even require “criminal background checks of the state eligibility-determination workers” who help residents learn about other federal assistance — but would suddenly demand additional checks for Obamacare Navigators.
The change would significantly impact a group like Community Council of Greater Dallas, which has decades of experience connecting low income populations to federal benefits. The group has hired 75 navigators to help guide Texans through Obamacare. “We’ve been through all of these issues, such as privacy and confidentiality,” Martha Blainethe director of the Council said. Under new rules proposed by Rick Perry, Navigators would have to get an additional 40 hours of training, undergo a rigorous state-administered exam [and] submit to background checks. The organization would then pay a fee to cover the cost of enforcing the regulations and report the names of the people they enroll to a state database.
The additional screenings also come as private companies and some states are moving away from discriminating against employees based on their past criminal records. The big box retailer Target announced last month that it will stop asking prospective employees about their criminal records on job applications, reasoning that the question weeds out many qualified candidates. Starting next year, the company will wait until making a provisional job offer before inquiring about a prospective employee’s record, giving potential hires the chance to make their case before an employer passes judgement. Last month, California enacted a law banning government employers from asking job applicants about their criminal record until later in the hiring process and at least “a half-dozen states have similar laws.”
Still, Republican legislatures and officials “in at least 17 states across the country” have thrown away their anathema to government regulations and set-up “all manner of bureaucratic roadblocks in front of the program.” Navigators are expected to help millions of uninsured Americans sign up for health insurance coverage and learn them about their options. But if states continue to raise the threshold for certification, the groups may have a hard time reaching the “minorities, low–income individuals, individuals with mental illnesses or substance abuse problems, and other vulnerable populations” that they’re meant to serve.