A federal district court judge in Jefferson City, Missouri has temporarily blocked enforcement of a state law that puts restrictions on individuals and organizations trying to help people sign up for health coverage under Obamacare.
Obamacare uses so-called state navigators and enrollment counselors to assist Americans who are looking to buy health plans. These navigators include doctors, nonprofit organizations, social workers, and community groups. They’re required by federal law to reach out to uninsured residents about different marketplace plans, spread the word about potential premium subsidies or Medicaid eligibility, and explain other pertinent enrollment details.
Although navigators have to be federally certified, the health law allows states to impose additional requirements they must comply with. At least 19 states generally opposed to the Affordable Care Act have passed such laws — and some states’ navigator requirements are so stringent that advocates say they prevent counselors from fulfilling their very purpose and speaking candidly with Americans seeking assistance.
For instance, Missouri’s navigator law, the Health Insurance Marketplace Innovation Act (HIMIA), prohibits federally certified navigators from discussing specific marketplace plans unless they also become state-licensed insurance brokers. Any organization found violating that rule would be subject to thousands of dollars in fines, and the burden of those requirements spurred Missouri nonprofit groups like St. Louis Effort for AIDS and Planned Parenthood of St. Louis to file suit against the state.
“Missouri has placed groups like St. Louis Effort for AIDS in an untenable situation,” said plaintiff’s counsel and former Missouri insurance commissioner Jay Angoff when he filed the lawsuit last winter. “If they comply with the Missouri statutes, they can’t perform the duties the Affordable Care Act requires them to perform, but if they comply with the ACA and do perform those duties, they violate the Missouri law and are subject to thousands of dollars in penalties for doing so. Those conflicts have created a culture of fear among the very people charged with helping Missourians comply with the new law.”
Judge Ortrie Smith agreed with that assessment. “The Court concludes HIMIA’s requirement that federally approved/licensed individuals and entities must also comply with additional licensing requirements constitutes an impermissible obstacle,” wrote Smith in his ruling. “[T]he suggestion that those designated to operate the [Obamacare marketplace] can do so only if they are also licensed as insurance agents demonstrates that the state law obstructs the federal purpose.”
A federal judge in Tennessee temporarily blocked a similar law in that state in October.
Missouri is likely to appeal the new ruling, which may eventually have broad ramifications for how well states can sign up residents for Obamacare. A recent study by George Washington University found that patients who go to clinics in states with strict navigator laws are significantly less likely to get information about the health law or find an insurance plan that’s right for them.