Galen Institute’s Grace-Marie Turned talked with EBA about conservatives’ view of both employers and brokers at a recent right-leaning Washington policy conference on health reform alternatives. She shares her conclusions on the Affordable Care Act, next steps on broker compensation, and more.

Q: How does the conservative health plan incorporate employers?

I think there’s a renewed respect about the role that employers play in the health sector and how important it is to have them engaged. Many people are left out of that system, but for the employers who want to provide health coverage and who have lots of resources to help educate their employees, to help provide incentives for them to do the right thing — very important. And I think you see that through some of the health plans that are coming out of Congress and some of the initiatives, to build in this floor so that employers can continue to provide health coverage. The tax treatment of health insurance coverage, nobody is talking about changing the employer contribution to health insurance and the tax treatment of that. Whether they want to provide that form of compensation as cash wages or in the form of health benefits, it still should be tax-deductible to employers.

Q: How do conservatives view brokers?

There’s been too little appreciation for the important role that insurance agents play, both in the creation of this law and also in its implementation. Many of them are basically external HR departments for small businesses where they go out and they find the best plan, they help explain it to employees, they deal with claims, they help educate employees about ways they can use that insurance policy in the way that its really going to be most beneficial. When they don’t have these agents, the employers are having to do this instead of what it is they’re in business to do. But we need these agents and we have to have them.

I know that there’s legislation that would allow their compensation to be apart from the administrative costs — the medical loss ratio, the 80%, the 85% that has to go to medical care, the rest of it has to go to administrative costs. Agents have a special role and we need to have a way for them to be compensated — they can’t do this for free. They need to be compensated for the valuable role they play. Many of them have been trying very hard to enroll people in the Affordable Care Act through the exchanges. They’ve spent hours and hours, nobody knows this business better than they do, and they’re having trouble. So we need to have agents encouraged to stay in the game, to make sure that there’s a respect for the value that they bring and that we build policies around supporting what they’re doing so that the system can benefit from their skills and expertise.

Q: What’s the Republican plan to fix the ACA?

It really can’t be fixed and I don’t think anybody thinks that it can be tweaked and you can just do something here — move this little dial, move that little dial. It’s really structurally flawed and one of the reasons is the administration has had to change it so many times on the fly, legally or not, and one of the reasons is that Congress has had to make 15 changes passed into law even before … it started to take effect. And so, it doesn’t work, it’s out of sync with this country and one of the reasons that so many people are saying ‘We want a better option’ and one of the reasons I think we see such fabulous attendance here at this conference both [physically] at the National Press Club but also via webcast, is I think people are hungry for an alternative. ‘What can we do so we can keep our doctor? So we can keep our health plan? So we can decide what health coverage that we want rather than having the government tell us what we have to have?’ So, the fact that there’s such an interest in this conversation I think is an indictment, really, of the Affordable Care Act. That people are saying, ‘This is not working, we need something else.’

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