Several members of Congress from both political parties expressed support last week for the role of the agent and broker post-health care reform. The legislators addressed a crowd of more than 700 at the National Association of Health Underwriters’ annual Capitol Conference in Washington, D.C. — including calls for the medical loss ratio provision of the Patient Protection and Affordable Care Act to be altered.
Sen. Mike Enzi (R-WY) acknowledged that agents are among “the most negatively impacted” by PPACA and reassured the audience that Rep. Mike Rodgers (R-MI) would soon bring a bill to the House floor that would alter the MLR calculation. Rogers, who also spoke, did not directly address such a bill, but said, “We’re going to work on trying to fix this medical loss ratio,” and called the effects of PPACA on agents and brokers “an example of an unconscionable consequence” of the legislation.
Freshman Representative Andy Harris (R-MD), a practicing anesthesiologist, called brokers a “vital part of the road to true economic recovery” and restated the promise to address the MLR calculations: “We’ll do things like attempt to exclude your fees from the MLR,” he said.
While Democrats Rep. Rob Andrews (NJ) and Sen. Mark Begich (AK) acknowledged their ongoing support for PPACA, both addressed changes that they believe should be made to the law.
Andrews wants to work on four specific areas: a role for the agent and broker in the sale of insurance; adjusting the medical loss ratio to move brokers to the medical side; including family members in calculating the small business tax credit; and fully utilizing patient responsibility and wellness initiatives in an effort to contain costs. “Some see your role as cost-added,” he said. “I see your role as value-added.”
Begich said areas that need fixing include increased cost containment, reimbursement rates, allowing importation of prescription drugs, and meeting the increased demand for health care by creating more jobs in the field. Addressing brokers and agents participation in the state exchanges, Begich said, “We want to make sure they’re part of the process.”
Joel Ario, director of HHS’ Office of Insurance Exchanges at the Office of Consumer Information and Insurance Oversight, praised the ability of agents to understand both the consumer and business perspective of the health insurance market and emphasized that there is nothing in PPACA that directly addresses the agent’s role in the upcoming state exchanges. While it’s possible that the federal government will weigh in on the agent’s role, Ario expects the issue to be left up to state discretion.
“On the small business side there’s almost unanimity,” said Ario. “I rarely come across a person who doesn’t say, ‘You know what, if the small businesses exchanges are going to work, the agents have to be part of the process.’ It makes sense to work closely with the agents,” Ario added.
During a question-and-answer session, Susan Voss, Iowa insurance commissioner and National Association of Insurance Commissioners president, was asked why the NAIC did not stand behind agents when making its MLR recommendations to the Department of Health and Human Services last fall when it kept brokers on the administrative side of the MLR. Voss insisted that the NAIC tried, but could not get HHS to agree on a broker waiver. However, she emphasized that the NAIC will “continue to lobby to keep agents in the process,” adding that HHS “can’t make this work without the agents — they can’t.”
