A key part of the Affordable Care Act takes effect on Oct. 1. That's when Americans shopping for health insurance can begin enrolling in the program.
Health and Human Services Secretary Kathleen Sebelius announced recently that the federal government is awarding some $67 million in grants to help health care groups around the country set up a network of so-called navigators. These helpers will reach out to people without health insurance, find out if they qualify for subsidies and assist them in shopping for coverage.
As a group, navigators will play a key role in helping carry out one of the Affordable Care Act's missions — to bring coverage to millions of people who currently have no health insurance.
Before they are certified and begin work, the navigators are required to undergo 20 hours of training and pass a test. "They are going to be required to adhere to strict data security and privacy standards, including how to safeguard consumers' personal information," Sebelius said.
As part of the enrollment process, navigators will look at tax records, take Social Security numbers and have access to sensitive health information. Sebelius says her agency has done similar work for many years with Medicare and Medicaid recipients and that the rules in place safeguard privacy.
But Florida Gov. Rick Scott, a Republican, says he believes the federal rules are inadequate. In Miami for his monthly Cabinet meeting, Scott said, "It is unclear how the federal government will prevent personal information from being stolen or otherwise misused."
Florida's Attorney General Pam Bondi is one of 13 state attorneys general — all Republicans — who sent a letter to Sebelius this month seeking information about the navigators. Among the questions: Will background checks be conducted, and how will HHS make sure they don't retain personal information and misuse it later?
The department is working on a response. "Our citizens need to know that that information that they're giving up could compromise their safety and security," Bondi said at the Cabinet meeting.
Earlier this year, the Florida Legislature passed a bill, signed into law by Gov. Scott, which mandates fingerprinting and background checks for all people hired as navigators, so a certain amount of the alarm expressed today seemed more about politics than policy.
Scott is a former hospital executive, who has long been a staunch opponent of President Obama's health care overhaul. He has dragged his feet on implementing most parts of the Affordable Care Act, including turning down federal money and declining to set up a state-run exchange where consumers can buy health plans.
At the Cabinet meeting, he asked Kevin McCarty, his insurance commissioner, whether he thought 20 hours of training for navigators was enough. McCarty said no.
Insurance agents can also sell health coverage policies under the Affordable Care Act, but HHS says navigators are one more resource — using consumer outreach and education to bring the uninsured into the market.
At last week's event with Secretary Sebelius, Jodi Ray, the director of one of the Florida programs hiring navigators, spelled it out even more directly.
You have to go where the people are, she said — clinics, community health centers, churches, schools. "We're going to be shaking the bushes where we know folks shop, where they eat, where they live, in their neighborhoods, in their neighborhood associations, where they get gas," Ray said.
Although he's opposed the Affordable Care Act, Scott surprised many earlier this year when he did a turnabout and said he supported expanding Medicaid in the state. Under the new law, that would provide coverage to about 1 million additional Floridians, with the federal government picking up the entire tab for the first three years.
The Republican-led Legislature, however, stuck to its opposition and the governor declined to push the issue. With his new comments, Scott appears to be returning to familiar ground — as one of the leading opponents of President Obama's health care overhaul.