After this hearing, TDI will consider all comments and suggestions and publish the rule in the Texas Register.
Senator Kirk Watson

  • Need to avoid the political straw man in this discussion
  • His bill prevents felons from being navigators, as well as prevents electioneering
  • Does not want to make it harder for navigators to do their job
  • SB 1795 was necessary because Texas chose not to create their own exchange
  • TDI has yet to provide justification as to why they went as far with these rules as they did
  • TDI has not providers any answers to the questions Texas Senators have posed
  • Told the Commissioner that this is inappropriate
  • Process matters here
  • TDI hasn’t explained the need for the arbitrary additional 40 hours of training
  • Was it the demand by the Governor?
  • TDI hasn’t explained how they came to the 13/13/14 hours on Medicaid, security and ethics, respectfully
  • TDI has not explained why navigators have to pay registration fees and the cost associated with additional training
  • TDI has not explained the need to show financial responsibility, like surety bonds
  • TDI has yet to provide a detailed timeline for the navigators to come into compliance with the proposed rules
  • There has not been a timeline for each step that must be completed
  • TDI has not explained how registration and limiting the use of the term “navigator” protects consumers
  • Under the currently timeline that all navigators must be in compliance by March 31, 2014, it would give navigators only about a month to get into compliance
  • Requests that the compliance deadline be postponed until after the enrollment deadline ends

Senator Sylvia Garcia

  • Believes these rules are obstacles and burdensome roadblocks that will prevent individuals from getting insurance
  • Believes that navigators should have the abilities to help get voters involved – voter engagement
  • The additional 40 hours of training is baffling – more hours required than any other state in the nation
  • Wisconsin requires the 2nd highest amount of training, 16/yr.
  • Limiting the term “Navigator” is unreasonable unless it is clarified to be just in the health insurance arena
  • There should be no fees
  • There should be an extension for individuals who speak English as a second language and training and materials should be made available
  • The implementation date should be extended

Representative Donna Howard

  • Mailed in comments previously so she will keep her comments short
  • Want to keep the uninsured population at the forefront of this discussion
  • Navigators are designed to help these individuals in particular
  • Doesn’t support arbitrary costs and training programs
  • Navigators are necessary, we must set them up for success

Representative Paul Workman

  • Sent a letter late last year urging the quick approval of the TDI navigator rules
  • Believes 40 additional hours of training is appropriate because insurance is a complicated subject
  • Poorly trained navigators do more harm than good
  • Fraud has already been documented in Texas
  • It is imperative that Texas adopt stringent rules for navigator, and encourages TDI to adopt the rules

Jessica Schlifer representing Senator Rodney Ellis

  • Rules impose excessive fees and training requirements
  • They will hinder Texans from making health care decisions
  • If these rules are truly about consumer protection, why are there exemptions in the rule for specific entities like insurance companies and insurance agents

Connor Kinney representing Representative Lon Burnam

  • Most concerned with the lengthy training requirement and the costs associated
  • Need to ensure access to navigators
  • No other state requires this amount of training, and TDI has not explained why navigators need this lengthy training
  • TDI has provided him documents that he is not allowed to release to the public

Robert McVay representing Representative Ryan Guillen

  • Many of the Representative’s comments have been covered
  • His goal is to protect people who need help – proud to have carried this bill in the House
  • Wants to ensure people get access to insurance who need it without getting ripped off

Dr. Martha Sphinx, Alamo Area Council of Governments

  • Collaborative partner for a navigator grant with the United Way of Tarrant County
  • Provides oversight of program in 11 counties
  • Have trained 16 navigators
  • Have been very selective
  • Background checked
  • Issued a special code to access navigator training ~30hr
  • Many exams throughout to continue training
  • 2 hours of HIPAA training
  • Professional liability coverage
  • The 16 navigators have performed magnificently
  • Participate in the HICAP program
  • Concerned that TDI’s rules put up some unnecessary obstacles
  • Skeptical that there is sufficient content for additional 40 hour training
  • Why pay for training when the community partner training is available from the state for free?
  • Recommends that changes take place after March 31st

Representative for Representative Ruth Jones McClendon

  • These rules are creating roadblocks
  • Troubled that the rules go beyond consumer protection
  • To broad, too vague
  • Need to clarify mission and scope of authority apply only to a small group
  • Concern that rules could negatively impact nonprofit organizations or hospitals, pharmacies, etc.
  • Would lie revisions based on all of these comments

Claude Andrews

  • Thoroughly know the problems of the older and uninsured populations
  • Suspend all rules, and allow federal rules to take precedent to expedite this program

Benjamin Hernandez, City of Houston Health Department

  • Concerned with proposed rules because they have experience with working with vulnerable populations
  • Certified benefit councils (CBCs) have decades of experience working with vulnerable populations, and they are similar to navigators
  • CBCs register with TDI and there is no fee
  • CBCs have 25 hours of training, and doesn’t believe it should be any different
  • Navigator program should mirror the CBC program

Clayton Travis, Mental Health Policy Fellow – Texas Cares for Children

  • Defines navigator too broadly, needs refinement
  • Rules are too burdensome
  • 40 hours of additional training seems excessive
  • Should uses existing training programs within HHSC and save tax payer dollars
  • With these rules, there will be a decreased likelihood that Texas families will find insurance
  • Many families do not know about their eligibility options or what is available

Houston Urban Business League

  • Believes the program in place is already working, but perhaps with a tweak or two it could be better
  • We don’t need changes that are over bearing

Maureen Milligan, THOT

  • Recommends navigator definition be more narrow
  • Additional cost, timeline and training requirements may not be legislative intent
  • Consider using Medicaid and CHIP requirements
  • Consider the impact to local taxpayers

JT Dwyer, Seton

  • Implement changes after the marketplace closes, not on March 31st because it is highly likely that the administration may extend the date
  • Believes that is the intent of many others have expressed today, but would like the language to be more fluid so it can move with any changes in the administration’s timeline