On the Third Hand: Poor People Don't Have Secretaries

Think about it: A woman might be dead partly she and her husband were too tired and broken down to read articles about PPACA very well, and none of the insurance agents who read the CNN stories about Leslie Elder or hospital patient assistance coordinators she might bothered to tell her that she should apply for PCIP coverage.

I personally know some uninsured people myself, and I think one thing that unites them is that no commercial insurance producer who is not a candidate for sainthood would really want to deal with them. They are creative, wonderful people who know a lot about some topics that interest them but who have not filed taxes in years, can’t actually afford to get help with filing taxes, lost any receipts or other documents that might be useful in preparing a tax form years ago, have no idea what a deductible or a co-payment is, and would be deeply offended if any of us personal friends or acquaintances tried to butt into their lives and bring order to their finances.

But those uninsured people are people, and, whatever the faults of those people and of programs like PCIP might be, I think they deserve to have help with finding and getting into those programs while those programs exist. Ditziness shouldn’t be a fatal condition, and parental ditziness should not doom the parents’ children. Few children have any say whatsoever over their parents’ tax forms.

Of course, HHS Secretary Kathleen Sebelius is going way, way out of her way to stick it to agents and brokers, even though a sizable minority of producers have backed PPACA, and even though producers tend to oppose PPACA with rational arguments rather than arguments that PPACA is bad because Barack Obama is a Muslim space alien Manchurian candidate who caused Hurricane Isaac and has oozed Muslim space alien Manchurian candidate cooties all over the Democrat Party.

I think Sebelius dumped a bucket of ice water over anyone in the insurance industry who’s at least sympathetic to the goals of PPACA in July, when she sent Rep. Adam Kinzinger, R-Ill, a letter in which she states that HHS sees no reason for the PPACA Navigators — the people who are supposed to help consumers, especially uninsured consumers, figure out the new bureaucracy created by PPACA — to have any kind of insurance department license.

Sebelius said the Navigator ombudsmen need not have producer licenses because they’ll simply be explaining how health insurance and the new PPACA health insurance exchanges work, not helping the consumers choose coverage.

Of course, in other settings, such as when regulators are looking at people who help consumers understand products such as annuities, life insurance policies and Medicare plans, the federal government tends to take a much broader approach to deciding who needs to have professional licenses. It seems reasonable for Sebelius to say that a Navigator needs a different kind of license than an ordinary health insurance agent, but it seems as if the only reason to say the Navigators need no insurance department supervision at all is to help the cash-strapped nonprofit consumer groups that want to get the Navigator contracts at the expense of, say, a spinoff from a traditional insurance agency that might be well-equipped to offer Navigator services on an exchange-fee-paid basis and also to get the Navigator service employees licensed as producers.

On the one hand: The people at those nonprofit groups seem like nice people. They seem as if they could do a great job of helping people like my uninsured friends deal with Medicaid and CHIP. I think they are a lot more on the same Ramen-noodle-eating wavelength than a lot of traditional producers would be.

But, on the other hand: Some of the half-starved, Ramen-noodle eating, third-floor-walkup inhabiting employees at the nonprofit groups may not necessarily be all that better informed or better organized than the clients. Maybe those folks really should get more attention from state insurance departments than traditional producers would, not less.

On the third hand: I think producers and producer groups should still do everything in their power to make the Navigator program as strong as it can possibly be, no matter how annoying they find it and how self-defeating HHS officials may sometimes be, because making sure poor people and sick people know about the help that’s available to them is a noble, important thing to do. If producers keep talking about effective ways to do things calmly and patiently, maybe the program organizers who don’t seem to be listening will suddenly wake up and listen and things will get better.