The 2010 Affordable Care Act (ACA) provides for the awarding of grants to individuals or entities that will help enrollees navigate the tangled process of signing up for health care coverage. In the case of Texas, which chose to allow the federal government to establish and operate its exchange, the grants are paid out by Washington but the state can impose additional standards on top of the 30 hours recommended by the Department of Health and Human Services.
The Texas Department of Insurance (TDI) has done just that, claiming that an extra 40 hours, fingerprinting, background checks and $800 in fees are necessary to prevent unsavory characters from gaining access to the personal information of the uninsured whom they are supposed to be helping. But some have claimed that the proposals are politically motivated—an attempt to jam up the ACA by preventing there being enough navigators to meet demand.
With all the attention being paid to prerequisites for ACA navigators, this ought to be the time that law makers and pundits reflect more broadly on the state of licensing. In fact, “The State of Licensing” wouldn’t be a bad nickname for Texas, where nearly a third of the workforce must have a government permission slip to earn an honest living. As IJ noted in our groundbreaking study, License to Work, Texas has the 17th most burdensome licensure regime, with many occupations’ state-mandated training periods being measured not in hours, but in years.
Take the case of Isis Brantley: hairbraider, teacher, entrepreneur, and…criminal? Isis was arrested in 1997 in Dallas for practicing hairbraiding without a barbering license. But braiders aren’t barbers, and it doesn’t take the 1,000 hours of barber training required for the license to learn how to braid hair. Eventually the state created an awkward half-reform by shoehorning a 35-hour hairbraiding license into the barbering law. Now, Isis has teamed up with IJ to sue for her right to teach traditional African hairbraiding without having to go back to barbering school for 750 hours and build her own 2,000 square-foot barber college.
Given the regulation- happy nature of the Texas Department of Licensing and Regulation, the extra hurdles for health insurance navigators hardly seems out of place or particularly harsh.
At least with regard to the proposed navigator standards, one state legislator has gotten religion on licensing. State Sen. Kirk Watson submitted a letter to the Texas Department of Insurance Commissioner, Julia Rathgeber, calling the extra hours “a purely arbitrary amount of additional training.” More recently, Watson also testified at a TDI hearing:
That kind of training requires real time and costs real money… Where did the additional 40 hour requirement come from, exactly? Who is it truly meant to help?
If only more lawmakers in Austin felt that way about the high barriers they impose on employment. In the case of Sen. Watson, he happens to be the original sponsor of the legislation that enabled the navigator roles in Texas, so he may have a special affinity for the program. But what Texas legislators should recognize is that almost all occupational licenses are politically motivated, typically at the behest of entrenched cartels.
By definition, occupational licensing is meant to be burdensome. In Texas it takes 350 days of training to become a cosmetologist; 1,825 days to become a preschool teacher; and $4,800 in fees to be a fisherman. Many of the occupations that are the targets of occupational licensing are best suited for people on the first rung of the economic ladder, who don’t have the resources or political power to fight back against unnecessary regulations. The government should take these burdens seriously no matter what kind of occupation we’re talking about. Hopefully the row over healthcare navigators will encourage sober conversation in Texas over the burdens placed on many of the same people the navigators are meant to be helping.
— Garrett Atherton
Garrett Atherton is the Outreach Coordinator at the Institute for Justice