A subcommittee of the House Committee on Oversight & Government Reform held a hearing today on the government’s Obamacare “outreach” program. Obamacare authorizes the government to provide information to the uninsured, and to assist them in obtaining insurance, through the use of “navigators.”
Today’s hearing addressed concerns of Republican committee members about how this process will work in practice. The only witness was Gary Cohen, deputy administrator of the Department of HHS’s Centers for Medicare & Medicaid Services (CMS), and director of the Center for Consumer Information and Insurance Oversight (CCIIO) within CMS.
Prior to Cohen’s testimony, Eleanor Holmes Norton, the District of Columbia’s representative to Congress, provided a moment of comic relief. In her opening statement, Norton denounced Republicans for refusing to get on board with Obamacare — the law of the land. Only in banana republics, she sniffed, are duly enacted laws thwarted by legislators who unsuccessfully tried to prevent their passage.
But Norton has no standing to complain about non-compliance with the law. She failed to file District of Columbia income tax returns between 1982-89, thereby evading roughly $80,000 in taxes owed. Only in a banana republic, I might have thought, would a scofflaw like Norton serve in Congress.
In any event, today’s hearing wasn’t about Republicans thwarting Obamacare; it was about overseeing its implementation. And oversight certainly seems necessary when it comes to Obamacare “outreach.”
The context is this: Obamacare is predicated on inducing young, healthy people, for whom purchasing insurance may not be the best cost-benefit option, to enter the insurance market and subsidize older, not-so-healthy people. Moreover, the Obamacare penalty (I mean, tax) for not purchasing insurance may be insufficient inducement, given that the cost of a policy may well exceed the amount of the “tax.”
In this setting, outreach becomes a tricky proposition. Will those who are conducting it (the “navigators”), for the avowed purpose of maximizing participation, present a fair and balanced picture to the uninsured? Cohen testified that they will answer all questions honestly, but will not volunteer the fact that the cost of purchasing insurance exceeds the Obamacare penalty.
Quite apart from the question of whether buying insurance is in the interest of the individual subject to outreach, it is important that navigators be honest, well-versed in insurance issues, and familiar with the tax implications of Obamacare (a citizen can find himself in big trouble if his relevant status changes in a given year and he fails to report the change to the IRS).
But Cohen admitted that under the regulations his agency is developing, navigators will receive only 20 to 30 hours of training through an online course. Furthermore, CMS apparently (1) will not require that navigators have a high school diploma, (2) will not require background checks of navigators, (3) will not automatically exclude felons, (4) will not automatically exclude individuals with prior involvement in identity theft, and (5) will not require that navigators have insurance to cover giving incorrect information about tax consequences. Nor, as a general matter, will navigators be subject to the standards applicable to census takers.
Yet navigators will have access to sensitive personal information about the citizens they assist. Although they are not charged with collecting information, they will help individuals fill out forms that contain personal information, such as social security numbers. Thus, they can obtain this information and, if they choose, use it or pass it along to others.
Individual navigators will be selected by organizations designated by CMS. Cohen testified that, naturally enough, CMS will look for organizations with experience working in the particular community in question, and for organizations that reflect the demographic characteristics of the community.
To me, that sounds a lot like “community organizers.” Accordingly, congressional Republicans are right to be concerned that some navigators will be use that status for purposes of partisan mischief.
Cohen (notwithstanding his tendency to begin his answers by saying “So” — when did aging bureaucrats decide to try to sound cool and breezy?) wasn’t a bad witness. But I doubt that his answers did much to assuage this concern.
Speaking of mischief, the committee highlighted two rather blatant examples of it. First, Obamacare calls on states to use navigators, but bars the federal government from paying for them. Yet the feds are paying for state navigators and calling them assisters. And, apparently, California tried to assist in this end-run by concealing information about its Obamacare spending.
According to Republican members, including subcommittee chairman James Lankford, HHS officials admitted that there is no statutory authority for their end-run around restrictions on providing money to states. But Cohen testified it was lawful because the states are required to provide assistance. “The function,” he said, “is the authority.”
The view that the government is authorized to do whatever it takes to accomplish its function — even in the face of statutory language barring the contemplated method — lies at the heart of the threat to liberty posed by the modern bureaucratic state as conceived by the left. Cohen provided a real service by articulating that position for all to hear.
Republican House members should take this message to heart. Standing alone, it should be sufficient reason to reject the Schumer-Rubio immigration proposal.
Finally, Republican members expressed concern over reports that HHS Secretary Sebelius has solicited money to use for implementing Obamacare from insurance and pharmaceutical companies — the very companies over which her department has regulatory power.
Cohen was asked whether Sebelius obtained an opinion about the legality of such solicitation before engaging in it. Cohen didn’t know.
It’s a good question, though. Perhaps she, or some government lawyer, concluded that “the function is the authority.”