Administration, to relief of local groups, responds to GOP demands on health care

The Obama administration moved Monday to insulate community nonprofits from demands of House Republicans, minimizing disruption weeks before a key part of the Affordable Care Act kicks in while potentially irking those who want to kill it.

Fifteen Republicans on the House Energy and Commerce Committee sent letters two weeks ago to 51 organizations that are receiving funds for "navigators" intended to help determine eligibility and enroll people in the insurance marketplaces due to open Oct. 1. The letters requested reams of information that some of the organizations, many of them small nonprofits, said was so detailed that simply responding would interrupt their work just as hiring and training had reached critical periods.

The administration told the groups last week not to respond if they didn't want to, and on Monday told the committee that it was doing so on their behalf. The response was unlikely, however, to include everything that had been demanded by the committee, including every e-mail, voice mail, and insurance company contact involving the navigator program.

Whether that is sufficient depends on why the Republicans were asking, said Timothy Jost, a law professor at Washington and Lee University who focuses on health care.

"If they actually want information, they've got it. If they want to bully and intimidate these nonprofits," he said, it may not.

Jost said he believed that the committee's letter to 51 organizations that received some of the $67 million awarded to more than 100 groups nationwide last month was not just another attempt to slow down implementation of the health law. Insurance agents have opposed the navigator provision from the start, he said, fearing that it could siphon business. He said that was unlikely to be the case.

Locally, groups preparing to train navigators expressed relief at not having to sort piles of paper.

The Pennsylvania Mental Health Consumers' Association in Harrisburg has just four employees, said Lynn Keltz, the executive director. The organization is hiring three outreach and enrollment workers and setting up other programs with its expected $380,000.

Even large organizations, such as New York-based Public Health Solutions, which is getting $400,000 for outreach in two North Jersey counties (and a separate award in New York state), said responding would have been a disruption. Since it doesn't have a date-stamp machine, for example, the group's employees would have had to manually number hundreds of pages of documents to meet the committee's precise request for submissions, said Jane Levine, general counsel.

"It is a real distraction," she said.

The administration's five-page response on Monday from Jim R. Esquea, an assistant secretary of the Department of Health and Human Services, was addressed to Rep. Fred Upton (R., Mich.), the committee chairman.

It gave blanket responses for all the organizations and said that certain documents specific to each - most, if not all, of which would already have been available - were enclosed. It also noted that the navigator awards are not technically grants, but cooperative agreements. Those give the administration far more continuing involvement than a grant.

A spokeswoman for the Republican committee staff e-mailed, "The committee welcomes [the Centers for Medicare and Medicaid Services'] interest in our investigation. We have had positive and productive conversations with navigators in response to our request, and look forward to continuing to do so in the coming days."

It was unclear whether the dispute will end there.

The committee's intent was clearly part of GOP efforts "to kill implementation of so-called Obamacare," said James A. Thurber, a professor at American University and editor of Rivals for Power: Congressional-Presidential Relations. Yet the administration's decision to intervene with requests that were sent directly to the organizations "is not very good politics," he said.

Advocacy in Washington normally "is much more sophisticated than this," he added.

On both sides.