Protecting the Role of the Agent
As implementation of the Patient Protection and Affordable Care Act (PPACA) progresses, NAHU is dedicated to ensuring continued access to the crucial services of state-licensed health insurance agents, brokers and consultants who work on a daily basis to help individuals and employers of all sizes purchase health insurance, use their coverage effectively and make sure they get the most out of the benefits they have purchased. Consumers' need for help from a licensed professional will only increase as the new health reform law is fully implemented and the compliance demands on employers and individuals increase.
The financial livelihood of independent health insurance agents and brokers nationwide is directly threatened by PPACA's medical loss ratio (MLR) requirements, which require health plans to treat independent agent and broker compensation as part of their administrative costs, even though agents run their own businesses, hire their own employees and pay all of their own expenses, such as professional liability insurance. It's critical that the health reform law's MLR requirements be changed so that consumers can continue to have access to professional independent health insurance agents and brokers. This provision has already resulted in service reductions and lost jobs and, if it is not changed, the economic disruption the MLR requirements have already caused is expected to accelerate.
Agents & Brokers in Health Insurance Exchanges
Health insurance agents and brokers have the experience, knowledge and skills to help people enroll in health insurance coverage both inside and outside of the health insurance exchanges. Agents and brokers don't just sell health insurance, they know health insurance and they are the only insurance assistors that have the resources to support a consumer throughout their entire plan year. Unfortunately, while agents and brokers are ready and eager to assist consumers in the health insurance marketplaces, they have not been given all the necessary tools to do so. NAHU is actively advocating for several simple changes to the marketplace that would allow agents and brokers to better and more easily assist their exchange based clients.
NAHU members are mostly small business owners, and they know all too well how the high costs of medical care and new health coverage requirements are hindering our nation's economic growth. When these cost drivers are combined with the myriad of new notice requirements and other compliance procedures that employers must now perform for and on behalf of their employees, it is no surprise that many companies are re-evaluating their decision to provide health coverage to employees in the future.
To ensure that employers continue to invest in their employees' healthcare needs in the years ahead, NAHU believes that many of the new health reform requirements that are discouraging employer-sponsored coverage should be addressed quickly.
Health Insurance Tax
The health reform law imposes a "health insurance fee" on health insurance companies. Also known as the health insurance tax, or the HIT, this fee on providers is ultimately a pass through fee onto consumers. This fee is administered in the form of premiums, increasing the cost of health care for millions of Americans. NAHU belongs to two coalitions that actively lobby against the HIT. In this capacity, NAHU and its coalition partners lobby in favor of legislation would fully repeal or delay the tax.
Great care needs to be taken when implementing health insurance market reforms to prevent cost increases in the existing private market system. No matter how fair a market reform idea might seem on its surface, it's not at all fair if it also prices people out of coverage options. NAHU suggests creating strong financial and insurance-related incentives for consumers to maintain continuous coverage—even when they are healthy. As experiences in some states have made clear, if you don't give consumers reasons to maintain coverage and you don't allow health plans to evaluate for risk, the cost of coverage ultimately increases. As of January 1, 2014 all states moved to a strict age band of 3:1. Prior to this nationally mandated change, forty-two states had in place a 5:1 age-band. NAHU is concerned that unless changes are made to PPACA's market reform requirements, they could deny many Americans access to affordable insurance, even if such insurance is federally subsidized.
The Cost of Medical Care
By far, the greatest access barrier to health insurance coverage in America today is cost. Constraining skyrocketing medical costs is the most critical—and vexing—aspect of healthcare reform. The cost of healthcare delivery is the key driver in rising health insurance premiums and it is putting the cost of health insurance coverage beyond the reach of many Americans.
All Americans, including Medicare beneficiaries, need to have a wide range of health plan choices available to them and the ability to pick the policies that best suit their individual needs. Congress should not limit the ability of seniors to access any Medicare coverage option, nor should they restrict senior access to the services of licensed professional health insurance producers. Policymakers should also refrain from financing deficit reduction measures or other healthcare reform programs on the backs of our nation's senior citizens by changing the funding of their private Medicare coverage options. Preserving the financial stability of the Medicare program, and its private option counterparts, is critical as well.
Long Term Care
As the baby boom generation ages, there will be an increased demand on long-term care services, which will place a significant and unsustainable strain on state Medicaid budgets. However, if more individuals were able to privately finance their LTC needs, the cost savings to both the federal government and the states in reduced Medicaid expenditures would be enormous, as Medicaid is currently the primary payer of American LTC costs. One simple change to federal law that would have far-reaching benefits would be to include LTC insurance premiums in Section 125 plans to encourage employers to offer such coverage to their workers as either a voluntary or subsidized benefit.