Texas Proposes Restrictive Rules For Health Care Navigators


The Texas Department of Insurance on Tuesday proposed new rules for federal health exchange “navigators,” or people tasked with helping consumers enroll in Obamacare, the Washington Post reported.

The department published the proposed rules on its website:

Requirements for navigator registrations would include:

  • Proof of U.S. citizenship or immigration status to obtain employment in U.S. 
  • Documentation of compliance with education requirements 
  • Fingerprinting and background check 
  • Evidence of financial responsibility to protect individuals against wrongful acts

Navigators would be prohibited from the following:

  • Charging consumers for providing information about health coverage 
  • Selling, soliciting, or negotiating health insurance coverage 
  • Recommending a specific health benefit plan 
  • Providing advice regarding substantive benefits or comparative benefits of different health plans 
  • Engaging in electioneering activities or financing or otherwise supporting the candidacy of an individual for government positions

Texas Gov. Rick Perry (R) proposed rules in September after he deemed federal regulation of navigators insufficient. A state law passed in May allowed the state to regulate navigators if federal rules were not sufficient.

Perry initially requested that navigators be required to keep a record of consumers they helped sign up for health insurance, which officials at the U.S. Department of Health and Human Services told TPM in September violated federal privacy laws. This rule did not appear in the proposal the Department of Insurance published Tuesday.

The Department of Insurance will hold a hearing on the proposed rules on Dec. 20, and will then hold a period of public comment until Jan. 6, 2014. The rules will take effect once the comment period has ended.

Supporters of the health care law said that restrictive rules for navigators in Texas are meant to keep people from enrolling under the new law.

“This is an attempt to add cumbersome requirements to the navigator program and deter groups from working to enroll Americans in coverage in the Health Insurance Marketplace,” Joanne Peters, a spokeswoman for the federal Department of Health and Human Services, told the Washington Post. “The navigator program is similar to Medicare counselors, which have existed for years and never faced this kind of scrutiny from Texas. Despite the state’s efforts, we are confident that navigators will continue to help Texans enroll in quality, affordable health coverage.”

At least 16 other states have also drafted or considered similar rules that may burden navigators, according to USA Today.

Masthead Masthead
Editor & Publisher:
Managing Editor:
Senior News Editor:
Assistant Editor:
Editor at Large:
Investigations Desk:
Senior Political Correspondent:
Front Page Editor:
Social Media Editor:
Editor for Prime & Special Projects:
General Manager & General Counsel:
Executive Publisher:
Head of Product:
Director of Technology:
Publishing Associate:
Front-End Developer: