A coalition of medical organizations and health care advocates has sued Missouri over its requirement that only state-licensed counselors can serve as navigators in a program aimed at helping consumers sign up for coverage under the new online health insurance marketplace.
A new Missouri law requires insurance counselors to receive at least 30 hours of training and pay a small fee in order to help online shoppers negotiate the federal insurance exchange. The law also compels insurance "navigators" to refer individuals who bought their health insurance from a licensed agent back to those agents when considering private coverage. Missouri's Republican-led Legislature opted against setting up a state-run exchange.
A lawsuit filed on Nov. 25 in U.S. District Court in Jefferson City said the state requirements "directly conflict" with the federal Affordable Care Act and place groups like the nonprofit St. Louis Effort for AIDS in an "untenable position," restricting their constitutional rights to free speech. The plaintiffs include Planned Parenthood of the St. Louis Region and Southwest Missouri; Missouri Jobs for Justice; former Democratic state lawmaker Jeanette Mott Oxford, who is now executive director of the Missouri Association of Social Welfare; a physician in Independence; a retired doctor in St. Louis County; and a Kansas City community organizer.
The Affordable Care Act "provides clear and controlling rules for the scope, role and duties of navigators and other consumer assisters," said Jane Perkins, legal director at North Carolina-based National Health Law Program and one of five attorneys representing those challenging the state law. "Missouri's law goes the unnecessary step to block the ability of consumer assisters to serve their intended function under the (federal law) which is to help consumers navigate the new marketplace and get enrolled in a qualified health insurance plan.
"Missouri is not only contravening the federal law, it is undermining and chilling enrollment efforts throughout the state."
The plaintiff's lead lawyer is Jay Angoff, who was Missouri's top insurance regulator from 1993 to 1998 and more recently spent several years as a top adviser to U.S. Department of Health and Human Services Secretary Kathleen Sebelius. Angoff oversaw the Office of Consumer Information and Insurance Oversight, which helped implement the federal health care law.
Missouri is one of at least 14 states that passed legislation that opponents of such restrictions refer to as "navigator suppression" laws. The licensing law was sought by insurance agents and brokers worried about fraud. The National Conference of Insurance Legislators provided lawmakers in Missouri and other states with specific bill language for the model legislation, state Sen. Scott Rupp, R-Wentzville, said in a previous interview with the St. Louis Post-Dispatch.
"The state has to have some authority over who are the navigators," Rupp said. "We have to be able to root out any bad apples."
Perkins called the legal challenge the first to contest a state law that restricts the activities of consumer organizations under the Affordable Care Act.
The suit names state Insurance Commissioner John Huff as defendant. A spokesman for the state agency declined comment Monday.