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  • Sen. David Sanders

Let the grandstanding begin. We mentioned a while back that the navigators and guides that will be hired in Arkansas as part of the Affordable Care Act (ACA) would likely be a political lightning rod for Republicans. Andy Davis reports this morning that the Arkansas Insurance Department‘s contract with Planned Parenthood to provide outreach workers has been delayed. AID is mum on why (no other contracts were delayed or denied). Rep. John Burris and Sen. David Sanders — who say they made complaints to Bradford about the contract — chime in with ready-made thumbs-down comments for Planned Parenthood.


At issue, of course, is that of the many healthcare services provided by Planned Parenthood, abortion accounts for 3 percent. So what does abortion have to do with the ACA navigators? Well, nothing. Here’s the deal: As part of the ACA, federally funded “guides” and “navigators” will be trained, licensed, and tasked with education and outreach to make sure that folks know they’re eligible for coverage and understand the process of enrollment. AID is contracting with a variety of not-for-profits, government agencies and private companies in the state to hire 637 guides to help facilitate the ACA enrollment process (including the “private option” pool) in every county in the state. These guides will be paid $12 an hour to do one task: help folks sign up for the insurance they’re eligible for. The entities given contracts are generally groups with experience working with the low-income populations that the guides will target, like Planned Parenthood. These entities don’t get money for their own purposes and they don’t do the training — they just hire people.

But…Obamacare and Planned Parenthood! Republicans lick their chops and here we go.


Controversy over these guides was inevitable. When AID first testified before the joint Public Health committee about them, Rep. David Meeks and Rep. Kim Hammer both put up a stink, with Hammer doing a quick Google search on one in his county and fretting that a not-for-profit focused on reproductive health and HIV prevention might use the guides as a “backdoor approach” to advance their “interests and agenda.” And it’s not just the hiring entities; the very idea of government workers with clipboards out in the community gets the conspiracy blood boiling. Meeks tweeted:


Part of the issue here is that conservatives and conservative groups probably aren’t chomping at the bit to go do Obamacare outreach. AID cast a wide net, but many of the groups that volunteered to participate have a focus, from reproductive health to fair housing to minority outreach, that is going to look suspiciously liberal to someone like Meeks. I’m going to go out on a limb and say that the Obamacare guides themselves might tend to lean left. That’s irrelevant to the task at hand, but it’s going to stir controversy.

The thing is, the guides are really important! The transition coming with the ACA is going to be complicated and confusing. For many opponents of the healthcare law, that’s happy news. Hiccups with the law’s implementation make for negative headlines they can trumpet. But the guides will be vital for the hundreds of thousands of low-income Arkansans newly eligible for health insurance trying to, well, navigate the system. And for the Republican architects of the private option, like Burris and Sanders, they should keep in mind that if signing up is too complicated or too much of a hassle for healthy people to bother, we’ll end up with an unhealthier marketplace, which means higher premiums (most of the folks in the expansion pool will have incomes too low to fall under the federal mandate to buy insurance). The guides will be a key factor mitigating against that dreaded “adverse selection.”

But why bother with policy details when there’s a chance to trash Planned Parenthood?