WASHINGTON—In the first case of its kind, Missouri v. St. Louis Effort for AIDS, the 8th Circuit Court ruled today that states cannot limit the ability of Navigators and other consumer assisters to help people enroll in insurance as the Affordable Care Act (ACA) intends.
Said Mehri & Skalet, PLLC partner Jay Angoff, who represented the plaintiffs in the case along with the National Health Law Program (NHeLP), “Missouri had placed groups like St. Louis Effort for AIDS in an untenable situation: If they complied with the Missouri statutes, they couldn’t perform the duties the Affordable Care Act requires them to perform, but if they complied with the ACA and do perform those duties, they violated the Missouri law and are subject to thousands of dollars in penalties for doing so.”
Angoff is a former Missouri Insurance Commissioner and head of ACA implementation at the U.S. Department of Health and Human Services.
According to Jane Perkins, NHeLP legal director, “Today’s ruling sends a powerful message not only to Missouri, but to policy makers in other states who are trying to make it difficult for their residents to get information about the health insurance options available under the ACA. The Court’s message: Don’t do that.”
The ACA and HHS regulations authorize various consumer-assistance entities, including Navigators and Certified Application Counselors, to help consumers enroll in health insurance coverage. In 2013, more than a dozen states—including Missouri—enacted laws that both impose additional licensing standards on consumer assisters and limit the activities they are permitted to engage in. In November 2013, two federally-certified consumer assistance counselors, the St. Louis Effort for AIDS and Planned Parenthood of the St. Louis Region and Southwest Missouri, along with six other plaintiffs, challenged the Missouri law in federal court.
In January of 2014, a federal district court enjoined the Missouri law, finding that the Missouri statute conflicts with and is therefore preempted by the ACA. The Eighth Circuit found provisions of the Missouri law unreasonable. For example, in what the circuit labelled a “no advice” provision, the Missouri law prohibited consumer assisters from providing “advice concerning the benefits, terms, and features” of particular health plans while the ACA requires consumer assisters to provide information to individuals “about the full range of health plan options for which they are eligible.”
Read the full opinion here.