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GOP Obamacare Foes Forget Bush's Medicare Navigators--like ACORN

November 12, 2013

Among the myriad tactics Republicans are using to sabotage the Affordable Care Act, the GOP attack on so-called Obamacare "navigators" is probably the most ironic. After all, the Bush administration similarly dispensed grants to dozens of community groups, hospitals, universities and non-profits to provide enrollment assistance for the Medicare Part D prescription drug program. And as it turns out, among those recipients of federal dollars from President Bush was--wait for it--ACORN.

Nevertheless, conservative agent provocateur James O'Keefe has added his guerrilla forces to the Republican campaign to discredit, damage and derail the navigator program. While the House GOP majority is investigating the navigators and demanding mountains of documentation to slow down their work, the National Journal reported two weeks ago, "whether by fees, background checks, tests, extra training, certifications, threats of civil penalties, or delays, Republican legislatures and officials in at least 17 states across the country have thrown up all manner of bureaucratic roadblocks in front of the program." And now, the National Review's John Fund is happy to announce, James O'Keefe has turned to the same covert action and disinformation techniques against the navigators he used to destroy ACORN.

The events of O'Keefe's video of a Texas navigator site run by the National Urban League are a familiar sight to viewers of his past efforts exposing Medicaid and voter fraud. Government-paid workers supposedly trained to uphold the law advise clients on how to lie on government forms, evade legal requirements, and ignore proper procedures.

If the GOP effort to negate the navigators seems vicious and cynical, it should. When President Bush launched his unfunded $400 billion Medicare Part D prescription drug program in 2004, his administration didn't just spend millions of dollars on television advertising, just like the Obama Department of Health and Human and Services is doing now. As it turns, the Medicare drug benefit passed by Republican majorities in Congress similarly relied on "navigators" to get the word out and get American seniors signed up.
In May 2004, the Bush administration announced it would be working with the Access to Benefits Coalition (ABC) to help roll out the Medicare drug discount card program that spring and enroll seniors in private prescription plans by 2006. "Seniors and persons with disabilities need to take advantage of the real savings and real money that is on the table for them," then HHS Secretary Tommy Thompson said. "Seniors with low incomes can save significantly through the discounts and the $1,200 to pay for their prescriptions. It's an opportunity they can't afford to pass up":

To help in the enrollment effort, HHS is making an additional $4.6 million available to organize and fund community-based organizations to help low-income beneficiaries learn about the Medicare drug discount card program and how to enroll. These funds are in addition to the $21 million previously made available to the State Health Insurance Assistance Programs (SHIPs), which provide one-on-one assistance to Medicare beneficiaries through trained volunteer counselors who are provided training from CMS...
HHS and the Access to Benefits Coalition (ABC) also have committed to working together in a complementary fashion as they target low-income seniors with education and enrollment programs. And HHS' Administration on Aging (AoA) and Indian Health Service (IHS) are reaching out to their constituencies to make sure they sign up for the program.
"We have an energetic coalition from the public and private sectors that wants to make sure seniors take advantage of the substantive savings the Medicare-approved cards provide," Secretary Thompson said. "We want to be aggressive in reaching out to these beneficiaries so they don't miss out on this meaningful benefit to help pay for their medicines."

And just who were the members of the Access to Benefits Coalition?
Many were the usual suspects. AARP, which supported both Bush's Medicare Part D and Obama's Affordable Care Act, was one obvious partner. The "public-private partnership of over 70 diverse organizations dedicated to ensuring that lower income beneficiaries know about and can make optimal use of new Medicare prescription drug benefits" also included the National Hispanic Council on Aging, an organization which is also now an Obamacare navigator. The conservative 60 Plus Association, whose celebrity spokesman Pat Boone would later call Barack Obama "a president without a country" who is "waterboarding America" over "socialistic health care and a host of other ultraliberal causes," also received dollars from the Bush HHS.
Other Bush administration Medicare Rx partners in the ABC might seem a little more surprising. Take, for example, ACORN.

Regardless, then as now the White House understandably turned to dozens of charitable groups, health care groups, trade associations and lobbying groups to help with the outreach for its new Medicare drug program hoping to bring prescription coverage to 43 million American seniors. Former Bush Health and Human Services Secretary Mike Leavitt acknowledged as much in his July 12 Washington Post op-ed, a screed which advised the Obama administration to learn from the launch of the Medicare drug program:

Before the program was implemented, only 21 percent of seniors had a favorable opinion of it, and 66 percent didn't understand what the reform would mean for them.
So we spent 18 months devising and implementing a campaign to explain the prescription drug benefit, prepare seniors as well as partners -- such as community groups, churches, pharmacies, insurance plans and state and local governments -- and then sign people up. A national bus tour supported each phase. The summer before enrollment (the same period that the ACA is in now) we logged more than 600,000 miles and visited 48 states. As secretary, I made 119 stops in 98 cities. I learned that with a program like the ACA, you can't count on Washington to sell it. You have to reach people where they live, work, pray and play.

The federal government has to "reach people where they live, work, pray and play" unless, Republicans now insist, a Democrat is in the White House.


Jon Perr
Jon Perr is a technology marketing consultant and product strategist who writes about American politics and public policy.

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