The federal Patient Protection and Affordable Care Act was passed to address both the cost of medical treatment through insurance and the fact that many people didn’t have coverage. The law is such a massive change in the health insurance landscape that it is taking several years to make it happen. The structure is slowly taking shape and there is already little hope that the “cost curve will be bent downward.” (A Newsweek broadcast journalist said while the legislation was progressing through the Congress that an “eight-year old would not believe that we are going to cover all these additional people in the system and save money doing it.”)

In fact, as attention turns toward getting people into the system, the Gallup organization reports that Texas has the highest uninsured rate in the United States, with 28.8% of residents lacking healthcare coverage in 2012. This is the highest for any state since Gallup and Healthways began tracking it five years ago.

How these people get covered is a major topic of discussion in the states these days, and the National Conference of Insurance Legislators considered and passed a resolution today specifying some state lawmakers’ concerns about the “navigators” who will be organizing coverage for the people who have none. Whoever receives the state grants to facilitate coverage will be responsible for articulating the differences between plans; matching family income against the premium subsidies; and, if the states listen to these NCOIL lawmakers, will also accountable for errors and other funny business with their clients’ Social Security numbers and other private information. States are encouraged to consider training requirements, specific enforcement, criminal and regulatory background screenings, along with other consumer protection.

Any group can apply for the navigators grants, and every state is required to have at least two. They could be church or veteran’s groups, the AARP, union or even ACORN (if it still existed), as far as I can tell.

We are entering a different health world with the assistance of the navigators. The states are right to do everything they can to get the uninsured the help they will need from folks who will be full of advice and cloaked in government authority.

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