JUNEAU -- Obamacare "navigators" have been targets of Republican opposition to President Barack Obama's Affordable Care Act elsewhere, but Alaska insurance regulators are defending the work the navigators are doing in the state.
The navigators are part of the new healthcare exchanges, and are designed to help Alaskans with the unfamiliar process. United Way of Anchorage and the Alaska Native Tribal Health Consortium have contracts with the federal government to provide trained navigators to help Alaskans figure out the process.
That's what they appear to be doing, said Brett Kolb, director of the state's Division of Insurance. He regulates both insurance companies and the agents who sell insurance policies.
"If navigators are doing what navigators were hired to do, navigators will not be selling insurance," Kolb said.
Alaska approach more moderate
Some states are actively trying to block Obamacare, with opponents hoping to prevent insurance enrollment. In Florida, Republican Gov. Rick Scott has blocked navigators from working to help residents sign up for insurance policies.
In Alaska, Gov. Sean Parnell has taken a more moderate approach, declining to have the state create its own exchange or expand Medicaid, but not taking the radical opposition of some other governors.
Kolb testified in Anchorage before the House Finance Committee's budget subcommittee looking at the Health and Social Services Budget.
Chairman Mark Neuman, R-Big Lake, questioned why the navigators were not required to register as insurance agents. He said he's asked Attorney Michael Geraghty the same question.
"His reaction was, 'That's a pretty good question, we probably should be looking at that,'" Neuman said.
Director Kolb said that he's been in touch with the navigator groups in Alaska, and that they knew what the laws are, and that they can only explain how the process works. Navigators cannot tell consumers which policy to buy.
"They seem to have a very solid understanding of that," he said.
The division has questioned them on how they respond when someone they're assisting as a navigator can't make a decision and requests the navigator to do so.
The navigators respond "that's not our job, at that point we refer them to an insurance agent," Kolb said the division was assured. Insurance agents, who are paid to give recommendations, are regulated and overseen by the state, he said.
Legislators wanted to know why navigators don't have to be registered with the Division of Insurance.
Kolb said he's not sure what benefit that registration would provide, because the division only regulates the sale of insurance.
"We've thought through that a little bit," he said. "I'm not sure what our role would be in regulating the not-sale of insurance," he said.
Lines drawn between navigators and insurance salesmen
That's something that other states have looked at, and something the division might be able to do, but he said he hasn't seen a need for Alaska navigators to be registered.
"They understand the roles and they understand where the lines are drawn. Hopefully they'll continue to operate as they are trained and how they are supposed to," Kolb said.
With the federally operated exchanges struggling, being called "obviously a mess" by one Democratic legislator, Kolb was asked about the possibility of Alaska creating its own exchange.
That's not realistic at this point, he said.
It would take a couple of years to get ready, and by that time there would be no federal subsidies and the state would be left footing the bill.
"It would mean the state would be taking on an ongoing expense of multiple millions of dollars," he said.
He also offered assurance that despite the problems with the federal exchange, insurance is still available in Alaska.
"There is still private insurance available, as there always has been," Kolb said. The two companies offering policies through the exchange, Premera Blue Cross Blue Shield and Moda Health, can always sell policies in person through agents, he said.
The exchange is simply a way to compare policy features and to qualify for government subsidies for those in certain income ranges.
"No one is forced to go to healthcare.gov, that's only the place for people to potentially qualify for tax credits" that subsidize coverage, he said.
Some legislators said that Obamacare was not working for their constituents, or sometimes their own families.
Rep. Tammie Wilson, R-North Pole, said her 26-year-old daughter makes only $20 an hour and can't afford the coverage available, and will be faced with a federal tax penalty.
Neuman said a disabled worker he knows is being forced by the government to buy a $700 a month insurance policy with only minimal coverage, or face a tax penalty.
Enroll Alaska, a private company that employs insurance agents to help people sign up for Obamacare policies, said that healthcare.gov has "numerous glitches within the system" and that they'd been only able to sign up three people so far.
Still, the company's Tyann Boling said they have made a big investment in the business and needs the exchange to work properly.
"We believe that it is going to function," she said.
She recommended that Neuman's disabled worker contact Enroll Alaska to see if there was a better deal available.
"That's an individual who should talk to one of our agents," she said.
Contact Pat Forgey at pat(at)alaskadispatch.com