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SB 120: Republicans, Insurers Team to Hamstring ACA Navigators with State Regs

If you can't beat 'em, regulate 'em!

Senate Bill 120 is the latest effort of the South Dakota Legislature to throttle the Affordable Care Act. It would impose background checks, exams, fees, and complicated regulations to make it harder for navigators to talk to citizens about the benefits available under the Affordable Care Act.

Health insurance and the Affordable Care Act are complicated. That's why the Affordable Care Act created "navigators." Kim Jones is South Dakota's statewide coordinator for this corps of ACA's public servants:

...people still have questions, Jones said, and since some people don't understand the ACA, she suggests they contact a Navigator.

"A Navigator can help make it less scary," she said.

To help Madison area residents, Jones will be at the Madison Public Library every other Wednesday beginning Feb. 5 to help with sign-ups before the March 31 deadline. Clients can call for appointments, or if possible she will take walk-ins [Jane Utecht, "Help for ACA Sign-up Coming to Madison," Madison Daily Leader, 2014.01.22].

The ACA navigators aren't out for profit. The navigators educate folks, often poor folks who have the hardest time getting access to health care, about the law and the marketplace. The navigators help people find more affordable health insurance options.

It is the very value of the navigators' work that has two forces working to slow them down. The insurance industry has been lobbying since the enactment of the ACA to impose burdensome state regulations on navigators. President Barack Obama already gave insurers huge concessions in contorting to the ACA to protect their market share, most prominently by taking the public option (which Rick Weiland now passionately advocates) off the table early in the ACA debate. But insurers can't even tolerate the "competition" they see in non-profit advisors helping people figure how to choose a good insurance plan under the ACA.

The insurance industry finds willing allies among Republican legislators who, failing to straight-up repeal the Affordable Care Act, now focus on throwing up roadblocks to its operation. At least seventeen states have passed regulations hampering navigators' work, eating into the budgets that navigators should be using to help people get insurance and forcing some navigator programs to close (which, make no mistake, is exactly Republicans' wish).

South Dakota's Senate Bill 120 is part of this big-business/Republican scheme to stop the navigators from making the Affordable Care Act work. It forces navigators, who already labor under stringent federal standards and training, to jump through the hoops of South Dakota's state bureaucracy. It subjects navigators to the Division of Insurance as if they were insurance agents, which they are not.

Republicans and the insurance industry alike fear the proliferation of satisfied customers of the Affordable Care Act. They have failed to win elections to overturn the law, so now they have to tie it down with legislative and bureaucratic tricks like Senate Bill 120.

p.s.: SB 120's 25 sponsors include two Democrats: Rep. Spence Hawley from Brookings, who sells insurance, and Rep. Bernie Hunhoff from Yankton, who may be suffering an Obama-esque urge to compromise.


  1. owen reitzel 2014.02.08

    I see one of the sponsors is my senator. Looks like I'll have another question to ask at the Cracker Barrel this morning

  2. Curt Jopling 2014.02.08

    Just out of curiosity is ALEC involved in this?

  3. Jana 2014.02.08

    And in the meantime. People will die because they don't have coverage. Children will unnecessarily severely ill with lifelong complications and families will be ruined physically and financially.

    But hey, they get an added bonus by burdening strapped rural health systems, town docs and we can pass those costs along to local county taxpayers and place a shadow tax on those with health insurance.

    Their hate for Obama and worship for the GOP carries a very serious and heavy price. I'm guessing they haven't even thought of these things.

  4. Porter Lansing 2014.02.08

    Just because the older angry white male conservative Republican hate machine can't stomach Obama SoDak people have to suffer? It proves their motivation is just selfishness.

  5. Donald Pay 2014.02.08

    This bill is unconstitutional as it violates the First Amendment of both the navigators and the folks needing advise.

    In several instances I've seen librarians assisting people to get signed up, and several librarians have become experts at this. I trust a librarian far more than some toady working for the insurance industry.

  6. Porter Lansing 2014.02.08

    The Dept. Of Justice will halt the implementation of laws or attempts to obstruct navigators and probably fine SoDak enough to completely deplete the emergency fund. Another case case of cutting off your nose because you're upset that your face is so ugly.

  7. Jerry 2014.02.08

    In Florida, they have calculated that Governor Rick Scott is directly responsible for 6 deaths each day for lack of Medicaid expansion. Here in South Dakota, it is not hard to calculate what the murderers in the republican party are doing to the working poor. As proven once again, the republican party, that is against abortion, is also for certain death for the innocent working poor and the cheer those deaths on with glee.

  8. joseph g thompson 2014.02.08

    So let me get this straight, you people think it is ok for a person convicted of identity theft to be a navigator under the ACA?

  9. owen reitzel 2014.02.08

    According to my senator this was brought up by the insurance companies.
    They don't want the untrained or convicts giving out advice on buying insurance off of the exchanges.

  10. Jerry 2014.02.08

    Always remember that we still have navigators to help the seniors get enrolled in Medicare Part D joseph g thompson. I must have missed your outrage at having them be your guide.

  11. Vincent Gormley 2014.02.08

    No we do not want Republicans and Tea party con artists doing the navigating.

  12. mike from iowa 2014.02.08

    Where did the person convicted of identity theft come from? These navigators aren't necessarily from the years ago defunct Acorn-as some wingnuts have been screaming. I would hope even wingnuts can get beyond their hate for Acorn,since it has been pretty much exonerated of most of the charges wingnuts made up.

  13. joseph g thompson 2014.02.08

    Don't have Medicare part D. Is it possible for someone to answer yes or no to the identity theft question?

  14. interested party 2014.02.08

    Mr. Thompson: you enjoy Tricare benefits, right?

  15. Jerry 2014.02.08

    I will answer that for you joseph g thompson. The answer is yes. A resounding yes! That way, they can throw the bum in jail for stealing the identity of Joe, the man who qualifies for a subsidy by making 12,000.00 bucks a year. Hang the bum high in the trees so the crows can feed for stealing Joe's identity to buy the Lexus he has been eyeballing.

  16. mike from iowa 2014.02.08

    I'm guessing you could have answered that yourself. If you are aware of a crime,turn it in. Why the riddles?

  17. joseph g thompson 2014.02.08

    You know I do Larry. Would like to see something like Tricare offered across the board to everybody, course the government is in the process of making changes in Tricare that might not make it so attractive.

    Asked the question only because I believe that if a navigator in South Dakota stole someone's identity the same people bashing the proposed law would be bashing the state because the Republicans allowed it to happen by not having a law requiring a background check.

    Am glad to see the two people who answered the question have no problem with felons having access to a persons private financial information. They were convicted and did their time, let them be.

  18. interested party 2014.02.08

    Former Sec. Bob Gates proposed that some time ago, Sir: always glad to see you writing here at Madville.

  19. grudznick 2014.02.08

    Is that your horse hideaway ad posted here, Larry? It is a swell ad and makes me not want to be mean to horses.

  20. Roger Cornelius 2014.02.08

    joseph thompson,

    Don't you feel some obligation to report a convicted felon operating as a navigator to the proper authorities.

    Please provide names of these felons.

  21. caheidelberger Post author | 2014.02.08

    Joseph, no, I do not want bad people working as ACA navigators. I am saying that the federal government is already handling training and oversight.

    Do IRS or FBI agents need separate licensing from Pierre to carry out their federal duties in South Dakota?

  22. interested party 2014.02.08

    not feeding old folks today, grud? horse burgers, ummm.

  23. Donald Pay 2014.02.08

    I would say that if South Dakota had taken the responsibility to set up its own exchange, it would have the right to impose training, fees, etc. That would fly in the face of normal South Dakota thinking, where any yahoo could be a school gunslinger, but, hey, the SD Republican Party is nothing if not a twisted pile of contradictions. However, South Dakota opted out of being responsible, and now they can't come expect to run the show. The whole argument about identity theft is as honest an issue as voter fraud, ie., it ain't an issue.

  24. mike from iowa 2014.02.08

    This reminds me of people who claim to stand in line and watch supposed poor people buy steaks and lobsters and energy drinks with SNAP cards and then drive off in brand new SUVS talking on their Obama phones. Everyone claims to personally know these crooks,but no one ever stops and turns them in. I have to doubt the veracity of these story tellers.

  25. grudznick 2014.02.08

    Martin He Dog, carrying his hackamore on a full belly

  26. joseph g thompson 2014.02.08

    Can't say as I disagree with you. If the feds have a program set up to screen navigators then South Dakota should let well enough alone. Does anyone know if the Feds have standards for the navigators or will they just provide a body. If the Feds do not do background screenings or have behavioral standards for navigators should South Dakota set standards for those navigators in South Dakota or should they allow anyone, to include convicted felons, to fill those positions in South Dakota? If a problem with a navigator crops up in South Dakota will Democrats blame Republicans for not establishing standards?

    Federal law enforcement agencies have strict guidelines as to who can be hired and what they must have as qualifications, do the ACA navigators?

  27. interested party 2014.02.08

    grud: what do you think about a hundred coal trains a day thru Wall?

  28. grudznick 2014.02.08

    Not in favor of it, Larry, but then Mr. Schieffer sold his railroad to some outfit that isn't going to haul coal and went belly up. The current class III owners probably won't be upgrading those tracks to haul that pretty black rock from the Powder River Basin any time soon. I'll be long dead.

    Cash your free milk shake cards. They're about to expire.

  29. WR Old Guy 2014.02.08

    It seems the state doesn't have a problem with volunteers working in the federally funded SHIINE program providing assistance on MEDICARE supplements, part D and the ADVANTAGE programs. They are currently looing for volunteers.

  30. caheidelberger Post author | 2014.02.09

    Volunteers?!? My goodness, they could prey on those vulnerable old people. They get just two days of training. Do those SHIINE volunteers have to pay a licensing fee or take any exams?

  31. caheidelberger Post author | 2014.02.09

    I like Donald's point, that if South Dakota has surrendered its responsibility for the exchanges to the feds, then South Dakota has also surrendered its right to regulate it. Can't have it both ways.

    Joseph, the links I provide above law out the federal regs for navigators. They seem to provide reasonable oversight.

  32. Anne Beal 2014.02.10

    I think you are forgetting that the navigators are competing directly with independent insurance agents. You know , those people who earn their livings helping people select their auto, home, life insurance. If you need assistance picking out a health insurance policy, go talk to the guy who sold you your auto policy.

  33. interested party 2014.02.10

    Uncompensated, ignorant clergy compete with qualified clinicians tax-free. Leslee Unrub enjoys state blessings while ruining lives.

  34. WR Old Guy 2014.02.10

    Navigators cannot recommend any insurance policy by name. They can only assist the applicant in filing for a health insurance policy through the federal exchange. They are subject to the rules and training as established by Health and Human Services as published in July 2013. This link is to the April 2013 notice for comment and the rules were adopted in July.

    The SHIINE program has done the same type service for years for those on MEDICARE without a problem. I surprised that the insurance industry hasn't tried to kill that program also.

  35. Jerry 2014.02.10

    Interesting WR Old Guy, I went to a Medicare meeting that was hosted by an insurance company and they specifically suggested Shiine for information to questions that folks there may have. This is not about an insurance company, this is about republican elitists and their desire to punish the white working poor of South Dakota.

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