Let’s conduct a poll. By hand signal. Anyone who discerns even an inkling of sincerity in the governor’s decision to bar Affordable Health Care “navigators” from county health department premises, slap yourself in the head.
Dr. Marc Yacht, former Pasco County health director, wouldn’t poll in favor of the gov. He called Rick Scott’s policy, ostensibly to protect patient confidentiality, “cruel and irresponsible,” charging that it will “significantly compromise a multitude of needy Floridians from getting critical health care.”
The Broward County Commission voted 8-1 Tuesday to defy Scott and invited navigators into five county-owned health facilities to answer questions about the Affordable Health Care Act and hook eligible people up with insurance exchanges.
The governor’s office, displeased by the Broward rebellion, issued an angry statement. “In an unprecedented move, the Broward County Commission today rejected the Department of Health’s guidance to protect patient privacy and ensure patient confidentiality in County Health Departments.”
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Not exactly “unprecedented.” The Pinellas County Commission had already voted to flout the governor’s order to shun the health insurance advisors. “I think it’s another round in the fight over Obamacare,” Commission Chairperson Ken Welch told reporters, “but at the local level we’re just concerned with getting good health care and information to all of our citizens.”
In Miami-Dade, the mayor and county commission seemed similarly inclined. “We welcome the federal government doing that,” Mayor Carlos Gimenez told the Herald. “From my understanding, it’s just helping people navigate the new laws. I don’t see any problems with that.”
Scott and his cronies seem to regard the healthcare crisis as a political abstraction (never mind that the state has some 3.8 million residents without health insurance, 500,000 of them below the age of 19). The anti-Obamacare political theater may enthrall Tallahassee and Washington, but it doesn’t play quite so well in a county like Miami-Dade, where local elected officials count 744,000 people under the age of 65 without health insurance. Only tiny, impoverished Hendry County has a higher percentage of uninsured residents than Miami-Dade’s 34.4 percent in Florida. The uninsured in Broward total 392,000.
Scott insists that his opposition to the navigators was born out of his deep concern that they would have access to confidential information from the applicants, that private records might come leaking out of the program.
This from the governor who wants to require all state employees to undergo drug testing, despite a court decision that found the proposal a massive and overreaching invasion of privacy.
Of course, the state and feds have been collecting Medicaid, Medicare, Children’s Health Insurance Program and the prescription drug assistance program info for years without much hubbub.
As the Herald’s Kathleen McGrory reported this week, a new state law (and perhaps the only accommodation the state Legislature passed in connection with the Affordable Care Act) requires the navigators to register with the state Department of Financial Services. The department then reviews each would-be advisor’s “qualifications, residence, prospective place of business, and any other matters that, in the opinion of the department, are deemed necessary or advisable for the protection of the public and to ascertain the applicant’s qualifications.”
These guys are vetted. Or they’re supposed to be. McGrory reported that as of Monday, only one of 43 navigator applicants had been approved. Perhaps the department is only being diligent. Or perhaps Financial Services is taking its cues from a governor bent on obstructing the healthcare law.
The burst of skepticism and anger after the statewide order banning navigators from health departments for bogus privacy concerns prompted the Florida Department of Health to try another, even more wanting explanation. A press release claimed that navigators would be wasting their time with county health department clientele. “Navigator services are for people who have money to pay for health insurance. Those are typically not CHD clients.”
The Department of Health seems to have missed the point of the Affordable Care Act.
There’s a bit more evidence that there might be something to Scott’s obstinacy than privacy concerns. Remember that Scott and Attorney General Pam Bondi joined other Republican-run states in the failed lawsuit to stop Obamacare. (They lost in the U.S. Supreme Court.)
This is the state that rejected $9 billion in Obamacare money over three years to expand Medicaid coverage in Florida. State leadership also backed a failed (and likely unconstitutional) state amendment in 2012 to block any Obamacare requirements that the uninsured buy health insurance. (About 51.5 voted down the initiative.) And Scott and the gang refused to set up state insurance exchanges and turned down the attendant federal incentive money to offset the costs, forcing the feds to improvise.
Navigators would help fill the vacuum caused by the state’s obdurate refusal to help its uninsured find coverage. But, of course, the governor has banned them from the very public health clinics where the uninsured come for medical help.
The governor may not be much concerned about their health care, but he’ll fight like hell to protect their privacy.