The Florida Department of Health has become the latest arm of state government to distance itself from the federal Affordable Care Act. It has ordered county health units not to allow outreach workers called Navigators onto their property to help uninsured people sign up for subsidized health coverage.
The order from C. Meade Grigg, deputy DOH secretary for statewide services, went out late Monday to the 60 local health department directors around the state. He wrote that the staff may accept informational materials from the Navigators to hand out upon request.
“However, Navigators will not conduct activities on the grounds of the health departments,” Grigg wrote. He said the policy was developed after some had asked DOH for permission to operate within state facilities, presumably because uninsured people often seek treatment there.
Dr. Marc Yacht, retired Pasco County Health Director, said the policy will “significantly compromise a multitude of needy Floridians from getting critical health care.” He called it “cruel and irresponsible.”
Grigg’s note said the policy is consistent with requests from other groups in the past, which he did not name. The order makes an exception for federally qualified health centers that are operating within local health departments; 41 such clinics in Florida received $8.1 million in federal grants specifically to help uninsured patients enroll in a health plan.
The Navigator program in Florida is being funded by $7.8 million in other federal grants, of which $4.2 million went to the Covering Kids & Families Program at the University of South Florida. USF is disbursing the money to 10 organizations around the state that will hire, train and supervise the outreach workers.
After hearing about Grigg's note, Health News Florida requested a copy and an interview with the author. Grigg was not made available, but DOH spokeswoman Ashley Carr sent a brief note citing the reasons the note was sent. There was a need for “clarity” and “a consistent message” across the agency, she wrote. But that wasn’t all.
“Navigators are not acting on behalf of the Department of Health,” Carr wrote, “and this program has raised privacy concerns due to the consumer information that will be gathered for use in a federal database.”
This echoes remarks by Gov. Rick Scott, Attorney General Pam Bondi and Insurance Commissioner Kevin McCarty at a Cabinet meeting in August. The officeholders, all Republicans who have opposed the Affordable Care Act in the past, said they worried the Obama administration wants to amass a huge databank of Americans’ health information or that the Navigators on their own might steal personal identifiers.
“It remains to be seen whether the information that people will provide, to give Navigators assistance, is safe,” McCarty said at the hearing. “The information given by applicants will be shared by the Health and Human Services and other federal agencies, including the Social Security Administration, Homeland Security and the Internal Revenue Service.”
At the time, as Reuters reported, U.S. Health and Human Services spokeswoman Joanne Peters said, "Contrary to Gov. Scott's statements, consumers will never be asked to provide their personal health information to the Marketplace, whether through a Navigator or not."
She added, "There is no such database of American's health information, and multiple independent fact checkers have debunked this claim."
Even if state officials were making it easier for them, the Navigators already faced a huge challenge in Florida, with its 3.8 million uninsured. They are still being hired and trained; after they pass an exam they must go through state-required criminal background checks .
They have to be ready by Oct. 1, which is when the federally operated online Marketplace for Florida is scheduled to open. The plans and prices that will be available in Florida have not yet been made public. Coverage could go into effect as soon as Jan. 1.
The Marketplace was created to provide comparison-shopping and subsidized coverage for uninsured people who don't receive it in the workplace or from some other source, such as the VA or a union. Some states elected to create and run their own Marketplace.