Republicans have done everything they could think of to repeal, defund, undermine and otherwise disrupt Obamacare. But they've failed, and that's why they've turned to a last-ditch strategy to stop the law and take away the rights of millions of Americans to get the health care they need.
Governors and state legislators are adopting state laws and regulations to sabotage the work of "navigators," the community organizations that will help consumers sign up for care. We are witnessing navigator suppression, and the Republicans' objective is simple: the harder they make it for navigators to do their jobs, the harder it will be for people to benefit from Obamacare.
Republican governors in 21 states are already - denying more than 5 million people health care by refusing to expand Medicaid. Navigator suppression is another way for the Obamacare haters to pile on and limit the reach of the law.
In a new report, Health Care for America Now conducted a detailed review of the most egregious laws and regulations found in 13 selected states: Arkansas, Florida, Georgia, Iowa, Illinois, Indiana, Maine, Missouri, Montana, Ohio, Tennessee, Texas and Wisconsin. These states are home to 17 million people without health insurance who are eligible for coverage under the health care reform law - fully 41 percent of the nation's uninsured.
The excessive requirements we found include such things as residency rules, extra fees, additional and unnecessary training requirements, superfluous certification exams, and prohibitions against navigators talking with consumers about the benefits offered by different plans. These measures constitute direct interference in the enrollment process.
For example, in Missouri, state and local officials are barred from providing any assistance to an exchange. In Florida, the Department of Health released a directive prohibiting navigators from conducting outreach at any of the county's 67 health departments. Fortunately, two big counties, Broward and Pinellas, are ignoring the order.
And just this month, Texas Gov. Rick Perry ordered the Insurance Commissioner to write new navigator regulations that require, among other things, that navigators complete 40 hours of training in addition to the 20 hours required by the ACA and then pass a "rigorous" state exam. Perry is even trying to limit the hours of navigator operations to 8 a.m. to 5 p.m. None of these rules is going to help get people covered in Texas, which has the nation's highest percentage of uninsured residents.
These roadblocks and restrictions have caused groups to withdraw from the program and return their navigator grants. This is why President Obama in Maryland today criticized the Republicans for creating these sorts of "roadblocks" for the "churches and charities" working as navigators to educate the public about enrollment.
The Republicans claim these laws are about protecting consumers. But Georgia's commissioner of insurance cleared that up when he boasted on video that he was doing everything he could to be "an obstructionist" to Obamacare.
Some of the Obamacare opponents may think they're attacking the President or the law, but mostly they're hurting real people with real health care needs. They're making it harder for people to buy health care. This isn't just an abstract political debate. For people without health insurance, this is about whether or not they can get medical care and get it without going bankrupt.
In a growing number of states, navigators are turning back their grants to help consumers because of navigator suppression policies.
Cincinnati Children's Hospital Medical Center, for example, which was planning to enroll people at three hospitals, turned back $124,000 in federal grant money because of state restrictions that went into effect this past July.
Cardon Outreach was going to educate people in Florida, Oklahoma, Pennsylvania, and Utah. It returned its $833,000 grant.
In West Virginia, the Attorney General, Patrick Morrisey, a vocal opponent of the ACA, launched a harassment campaign against one of his state's navigators, West Virginia Parent Training and Information. Morrisey posed dozens of questions to the group about its navigator program and gave them only 14 business days to respond. Instead, the organization decided to send back its $366,000 enrollment grant.
The Lower Rio Grande Valley Development Council along the Texas border with Mexico just returned $288,000 in navigator grant funds this week in response to Perry's attack, and four other Texas navigator groups reportedly may follow suit.
These state officials have taken their cues from members of Congress. Republicans on the House Energy and Commerce Committee sent letters to 51 groups in 11 states, including food banks, legal aid societies, and United Way organizations. The committee demanded that these groups produce reams of paperwork about their operations and schedule a briefing of the committee by Sept. 13. The only purpose of the inquiry was to interfere with the ability of these groups to prepare for enrollment. That's sabotage, and it's a politically motivated abuse of power.
Many of the states now going after navigators are also passing laws to suppress voter registration and make it harder for minority, low-income and elderly residents to participate in elections. Just like voter suppression, enrollment suppression is an attack on people's right to be healthy and free from financial hardship and bankruptcy.
That's why navigator suppression shocks the conscience: it perpetuates the systematic denial of affordable health care to huge numbers of the most vulnerable individuals in our society, especially those in minority and lower-income populations.
Thanks to Obamacare, Americans no longer have to worry about getting the health care they need. They only have to worry about the Republicans taking it away.
Ethan Rome is executive director of Health Care for America Now (HCAN), the nation's leading grassroots health care coalition. He has been a community and labor organizer for more than 25 years.
This article also appears in the Huffington Post.