1. Health

Gov. Rick Scott, Cabinet raise concern for privacy on health care exchanges

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Published Aug. 20, 2013

MIAMI — Gov. Rick Scott and members of the Cabinet, meeting in Miami on Tuesday, questioned the safety of private information supplied by Floridians to federally-funded "navigators" and others who will help consumers enroll in health insurance programs through online exchanges scheduled to launch Oct. 1.

Casting the navigators program as a federal government effort to create a database of personal information with no clear purpose, Scott and Cabinet members including Attorney General Pam Bondi and Chief Financial Officer Jeff Atwater said they worried that the information could be abused by identity thieves and others.

"My concern is that we have no control over how the data's going to be used,'' Scott said after the meeting at Miami Dade College. "You should know if they're going to have your information, how it's going to be used, when they're going to use it, what agencies are going to have it."

"This is a consumer protection issue. This is an identity theft issue," said Bondi, who sent a letter on Aug. 14 along with 12 other state attorneys general asking Health and Human Services Secretary Kathleen Sebelius about the privacy concerns. They asked for a response by Aug. 28.

But U.S. Rep. Debbie Wasserman Schultz, D-Weston, who chairs the Democratic National Committee, slammed the state's Republican leadership for declining the chance to develop Florida's own health care exchanges — including the navigator program — and instead opposing the Affordable Care Act at every turn.

Because Florida legislators declined to operate a state insurance exchange, and instead defaulted to the federal government, HHS will run the exchanges.

"They certainly had the opportunity — and forfeited the opportunity — to completely control and run our own state exchange, in which they could have set in place the parameters for those navigators," Wasserman Schultz said. "Forgive me if I don't trust that their concern is genuine when these are the primary opponents of health care reform.''

HHS officials said the information transmitted with a health insurance application will not be stored on a data hub. Rather, it will be part of secure, instantaneous data transfers. They said navigators will be required to comply with privacy and security standards, and will never obtain information without consumers' consent.

Additionally, HHS spokeswoman Joanne Peters noted that the navigators program has precedent in existing government health care programs.

"HHS has run in-person assistance programs for years to help Americans enroll in Medicare and Medicaid,'' she said.

Navigators, as well as assisters and counselors, will educate consumers about new health insurance options and walk them through the enrollment process, though they will not be allowed to sell insurance policies or steer consumers to specific plans.

In many cases, navigators likely will be helping individuals who are buying health insurance for the first time, or who are not proficient in English.

Once the online application has been filled out, the navigator will not be able go back and retrieve it.

Personal information provided by individuals enrolling through the exchanges will not be shared with all federal agencies, only those relevant agencies that will use the data to determine an applicant's eligibility — the IRS, which will verify eligibility for federal subsidies to purchase insurance; the Department of Homeland Security, which will verify the immigration status of applicants (undocumented immigrants will not be eligible for federally-subsidized health insurance); and the Social Security Administration, which will verify identity, age and other information.

Those agencies, in turn, will send back to the exchanges only the relevant information. For example, the IRS will send an applicant's adjusted gross income, but not their entire tax form.

All the navigator and consumer will see on their end is that they entered the information, and then the online exchange will display a determination of what subsidy the applicant qualifies for.

This year, Florida's Legislature passed a law requiring navigators to register with the state and submit to criminal background checks and fingerprinting. But Insurance Commissioner Kevin McCarty, who delivered a presentation Tuesday to the Cabinet on the privacy concerns related to navigators, said those regulations will not apply to other federally funded workers, such as assisters and counselors.

McCarty also told the Cabinet that the federal government will have much of the information that would be needed to prosecute a rogue navigator, and it "remains to be seen" if the government would share that information with state officials seeking to prosecute.

Scott framed his concerns in a political context apparently aimed at the Obama administration's domestic spying scandal, in which the National Security Agency conducted unauthorized surveillance of Americans and foreign intelligence targets in the United States.

"We cannot stop the president's plan to create a new federal database that compiles personal information on all Floridians,'' he said.

Scott also questioned the adequacy of the 20 hours of training — reduced from 30 — that navigators will receive.

McCarty said 20 hours is not enough time to properly train someone on the complexities of health insurance. He said licensed health insurance agents and brokers in Florida "study for months" to prepare for examinations to test their financial understanding of health insurance plans.

He added that Florida also screens health insurance agents and brokers working for private companies. He said the screening process includes criminal background checks, fingerprinting and monitoring. And he emphasized that insurance companies are considered liable when their agents misuse consumers' private information.

Florida's navigators were announced last week, when Sebelius visited Tampa to announce $67 million in federal funds had been awarded to navigators across the country, with $7.8 million for programs in the state.