NASHVILLE, Tenn. -- Representatives of organizations seeking to help the uninsured sign up for health coverage under the Affordable Care Act reacted with dismay, anger and disappointment Thursday after Tennessee issued emergency rules restricting their activities.
The rules require their employees and volunteers to be fingerprinted, undergo background checks and limit the advice they can give to people. The Tennessee Department of Commerce and Insurance said the agency is protecting consumers from fraud, but religious and social service leaders question the motive.
The rules were issued less than two weeks before the Oct. 1 launch of the Health Insurance Marketplace, where the uninsured can shop for policies and possibly qualify for subsidies toward buying coverage. Organizations are uncertain how to comply and worry that it will delay their work.
"It binds people's hands to bring about resources that can actually impact someone's journey of health or illness purely for political motivation," said Timm Glover, chief mission and ministry officer for Saint Thomas Health in Nashville. "It has no concern for the common good of society. It flies in the face of human dignity."
And critics of the rules say they don't protect anyone from fraud because scammers aren't going to register with the state.
Bipartisan legislation overwhelmingly passed by the state Legislature this year authorized the state agency to regulate navigators and certified application counselors. Navigators are tasked with doing outreach activities to inform people about coverage opportunities, while counselors can help them apply for coverage. The state law prohibits them from selling, soliciting or negotiating any insurance policy.
It sets a penalty of up to $1,000 for each violation.
"Navigators and certified application counselors will have access to consumers' most personal information, including tax returns, Social Security numbers and health history," said Tennessee Commissioner of Commerce and Insurance Julie McPeak. "It is incumbent on us, working to implement the will of the General Assembly, to ensure that individuals who are not of good moral character cannot act as navigators or counselors in this state."
A spokesman for the agency said the rules are not intended to limit people from sharing information about the federal health law in their churches and communities "as long as they are not specifically walking consumers through qualified health plans or the exchange." However, volunteers — many of them with religious organizations — are receiving federally approved training to help people enroll for coverage online.
"I guess the question we're asking is, 'Where does it stop?' " said the Rev. Merrilee Wineinger, coordinator of holistic living and outreach for the Tennessee Conference of the United Methodist Church. "The state is coming in and telling churches that they can't counsel. It's something that we have been doing so long. They are regulating how we do ministry. Where does it stop?"
The regulations did not undergo any public hearings because they were issued as emergency rules, said Beth Uselton, a program officer with Baptist Healing Trust.
"If you have unscrupulous actors, they are not going to register with the state and then go through this process," Uselton said.
Kate Abernathy, public information officer for the state agency, said it planned to issue registration certificates. People can ask to see them and then call the commissioner's office to verify credentials. The federal government also will issue certificates, she said.
Officials with Metro government agencies, including the library system and health department, wonder how the law will impact their activities.
"We have no idea at this point what we can provide on Oct. 1," said Tricia Racke Bengel, associate director for collections and technology services at the Nashville Public Library. "We have never been put in the position — ever — of saying we don't know what we can tell you on Oct. 1. We just think it's a ridiculous situation."
The Rev. James Thomas, pastor of Jefferson Street United Methodist Church, thumbed through his wallet for the business card of a U.S. Department of Justice official. He said somebody needed to fight for "the least and the left out," the uninsured people of Nashville.
"What they are doing is interfering with the benevolence program of the church," Thomas said. "We need — as a black church, as a congregation — to sue somebody."