Obamacare: Out of Government Compliance

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By USDR

Yesterday, in a letter to President Obama, leaders for nonprofit voting rights organizations Demos and Project Vote alerted the White House that the application process for benefits under the Affordable Care Act (ACA) currently violates the National Voter Registration Act of 1993 (NVRA).

In the letter, the groups urge the Obama Administration to take immediate steps to bring federally facilitated health benefits exchanges (FFEs) into compliance with federal law.

The letter was sent on the very same day that the Presidential Commission on Election Administration released its long-awaited recommendations for improving the voting experience in America. Significantly, one of the Commission’s findings was that “the election statute most often ignored…is the National Voter Registration Act.” The report calls for increased enforcement of the NVRA, and focuses specifically on the law’s requirement that certain government agencies provide voter registration services in coordination with other client transactions.

“We strongly support the ACA, and the President’s efforts to ensure that all Americans have access to quality, affordable health care,” said Michael Slater, Executive Director of Project Vote. “But, as the President’s own commission point out, the Administration cannot ignore clear violations of one of our most important federal voting rights laws.”

“Ensuring that all eligible Americans are registered to vote is key to ensuring a democracy of, by, and for the people,” saidBrenda Wright, Demos Vice President of Legal Strategies. “Agency-based registration under the NVRA is a critical tool in making voter registration convenient and accessible. If the NVRA’s requirements are implemented properly for those enrolling under the ACA, millions more Americans will have the opportunity to join the voting rolls.”

The National Voter Registration Act was enacted 20 years ago with strong bipartisan support from Congress. It simplified the voter registration process and made it more accessible by requiring convenient voter registration opportunities to be provided in certain instances when Americans interact with their government. For the last 20 years, states have offered voter registration services in tandem with driver’s license transactions, Medicaid, and other government programs. Over 140 million Americans have applied to register to vote because of the NVRA.

The NVRA is very specific about when and how voter registration assistance must be provided. Any time an applicant applies for benefits, recertifies, or submits a change of address, the covered agency must:

ask the applicant, in writing, whether he or she would like to register to vote or update his or her voter registration address;
distribute a voter registration application form, unless an individual declines in writing;
inform the applicant, in writing, that no one may interfere with his or her right to register to vote or not, right to privacy while registering, and right to choose a political party; and
help the applicant complete the voter registration application form, to the same degree as assistance is provided in completing benefits application forms.

Because the benefit exchanges provide public assistance within the states, including Medicaid, the Obama administration has acknowledged that the exchanges must provide voter registration services. However, the current FFE application process does not fully meet the NVRA’s requirements.

Currently, the online portal contains a question about voter registration, but it does not employ the required language or contain the necessary disclosures or disclaimers. Far from “distributing” a voter registration form with each transaction, the online portal merely provides a link to a website. Many applicants do not have access to a printer to print out the form, and even if they do, the applicant must then hunt for the voter registration form, download and print more than 20 pages of mostly irrelevant information, fill out the application by hand, and mail it. Finally, FFE staff who provide assistance with health care benefits are not being trained or required to provide clients with equal assistance in completing voter registration applications.

As a consequence, several million Americans already have lost out on the opportunity to register to vote. Millions more will be denied this right if the Administration does not take action in the coming months.

In the letter to the White House, Demos and Project Vote call on President Obama to direct the Department of Health and Human Services to make the changes necessary to the FFE process to bring it in line with the law.

“We respectfully request that you direct HHS to bring the FFEs into compliance with all the requirements of the NVRA,” the groups write.

In the past several years, Demos and Project Vote have led a nationwide effort to advocate and litigate for NVRA compliance in the states, with dramatic results. Successful efforts to enforce compliance with the public agency requirements of the NVRA have accounted for over 2 million applications in Missouri, Ohio, Georgia, and other states.

The letter concludes that the groups “look forward to continuing to work with your administration to advance our shared interest in expanding access to quality, affordable health insurance, and ensuring that eligible Americans are provided with the opportunity to register to vote.”