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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Bill on Nixon's desk could add barrier in enrolling Missourians in ACA marketplace


 Update: Gov. Jay Nixon signed SB 262 into law on Friday, July 12. 

A bill that was pushed by the state's insurance agents association could create a barrier in getting Missourians enrolled in time for the new online health insurance marketplace  one of the key parts of the health care reform law.

On Oct. 1, any American looking to buy health insurance can enroll in their state’s online insurance marketplace. If you meet the income criteria, you might even be eligible for tax credits to help you pay for an insurance premium. The Missouri Foundation for Health estimates about 300,000 Missourians can get financial help to pay for their premiums through the marketplace.

And to help this pretty huge group of people get enrolled on the website, the federal government has a program called “navigators.” Organizations in Missouri are eligible for about $1.3 million in grant money to hire individual navigators. The federal government provides 30 hours of training, an exam and certification.

But, “Missouri has created a parallel system requiring again, certification, training and an exam. Seems almost duplicative,” said Lisa D’Souza, a health policy fellow at Saint Louis University. 

The system she’s talking about is a provision of SB 262, a bill that's still waiting for an action by the governor as of Tuesday evening. D'Souza recently wrote a policy brief with concerns about the bill's navigator provisions. 

Some of D'Souza's concerns has to do with the timing. The federal government is expected to announce the winners of the navigators funding grant around August 15, less than two months away from when Missourians can start enrolling in the marketplace. There's already some concern about how well prepared navigators can become in such a short time, and SB 262 could complicate that even further. 

“There’s a provision in the bill that says navigators can’t receive funding until they’ve gotten licensed,” D'Souza said. 

If the bill does become a statute, the Missouri Department of Insurance is only going to have a little bit less than two months before August 15, the federal grant award date, to locally license navigators so they can actually get the money. And people would have to go through the training without confirmation of the federal grant. 

“Are people going to want to go through that [licensing process] not knowing if they were selected?” D'Souza says. 

Larry Case is the executive vice president of the Missouri Association of Insurance Agents, one of the organizations that had a hand in getting that navigators license requirements passed. He sees the additional training for new navigators as necessary.

“There are no requirements in state law about who's eligible for a navigator,” Case said. “If they're going to be discussing issues with the public, they need to have some sort of training and be knowledgeable in their field to know what they're talking about.” 

D’Souza says she believes the 30-hour training by the federal government should be enough to train the marketplace navigators, and that the local licensing would be an additional burden.

“It seems like it just may be extra work without any real benefit to the people of Missouri,” D'Souza says. 

She says some language in the bill's navigator provisions seems to hint it wants to protect the insurance agents and brokers industry. 

Speaking to KCUR earlier this year, Sen. Scott Rupp (R-Wentzville) expressed concern about keeping the insurance broker industry in the game.

“I think it [the likelihood of being involved] is pretty good because there are some serious, legitimate concerns,” Rupp said. “If it’s done incorrectly, you could almost eliminate the entire independent insurance broker. Obviously you wouldn’t want that to happen, you could almost wipe their whole industry out if we’re not careful.”

D'Souza says insurance agents and navigators will be dealing with different insurance markets.

“The people who are going are really going to be eligible [for tax credits in the marketplace] are people who haven't been able to buy insurance from insurance brokers, they're sort of excluded from that market,” she said. 

Similar navigator-licensing bills and provisions have popped up in different states across the country, including Arkansas, Utah, Georgiaand New Mexico

Gov. Jay Nixon’s office says by Friday, he will be done taking action on bills passed in the latest legislative session. If he doesn’t take action, bills become laws without signature.


Harum Helmy started as KBIA's Health and Wealth reporter in January 2013. She has previously worked at the station as a news assistant, helping assign and edit stories by student reporters. Harum grew up in Jakarta, Indonesia and graduated from MU with degrees in journalism and anthropology in 2011. She's trying to finish up an MA in journalism.
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