Is Health Insurance Exchange Navigator Program Attracting Criminals

The health insurance exchange navigator program has come to be seen as a life savior for the Obama administration after the fiasco. With a crumbling website and all hands dedicated to keeping it from falling, the health insurance exchange navigators are making sure that people are able to go through the enrollment process. Some navigators are also utilizing the skills gained through the exchange navigator program and helping people with paper applications, especially when the online applications fail. In a nutshell, the millions of dollars given as grants to these navigators are being put to good use in every state.

However, there is a downside to this seemingly angelic attempt by organizations to help people enroll on the marketplaces. In the last couple of weeks, it has come to the notice of the government that several criminals and shady characters are making use of the exchange navigator program to make money. There have been several cases that have demonstrated hidden agenda of working navigators, including a suggestion for applicants to lie on their profile so that they can save a few dollars on premiums. For instance, in an incident in Dallas, three navigators were fired when they were caught on video trying to advise a senior citizen to not to mention tobacco use on his application as it might lower his chances of getting subsidy and low premiums.

Another incident of New York shows the loopholes in the health insurance exchange navigator program, and how a car service company, a cupcake bakery, and a spa saloon were listed as health insurance exchange navigators. While it is not clear whether this was done intentionally, it still exposes the gaps that exist in the whole selection process.

In the light of these events, several other states have become wary of criminals and illegitimate people making use of the exchange navigator program for their hidden agendas. Florida, for instance, has made sure that since these navigators have access to SSN and tax information of applicants who utilize their assistance, all such navigators need to be checked for a criminal history, including a fingerprinting check and criminal background check. Several other states are thinking to follow suit.

However, while these measures show the administration’s vigilance in selecting the right candidates for a job that puts them closer to sensitive information, such actions could cause a severe side effect which the government cannot sustain at the moment – obstruction of navigator function. Several navigators have complained that after receiving the federal grant, they have had to go through extensive interviews again and again for verification of their credibility. While these navigators do not find this to be extremely wrong, they cite wastage of time that could be used for enrolling people, as a major concern.