The issues with the Affordable Care Act go far beyond a botched enrollment process, Sen. Kelly Ayotte (R-N.H.) told members of the National Association of Health Underwriters Tuesday at the organization’s annual Capitol Conference. Made clear by recent town halls she’s held, Ayotte says there is “sheer confusion” among the general public on everything from co-pays and deductibles to provider network limitations.

As a result, “now more than ever, your advice is critical,” she told the more than 800 NAHU members gathered in Washington. However, Ayotte said the broker’s ability to provide advice remains in jeopardy, thanks to the medical loss ratio provision of the ACA.

A “proud” co-sponsor of the Access to Independent Health Insurance Advisers Act, which would remove commissions from the MLR calculation, Ayotte told attendees, “I know that if we don’t pass this law and the status quo stays the way it is right now that you are going to be put in a very difficult position and it will greatly restrict your ability to thrive and grow. But most importantly, it’s going to restrict the advice and the counsel that you provide that is critical to people who want to have good access to health insurance.”

She did not provide a timeline for expected passage, yet said, “I hope we will go forward with it, because the last thing we want to do is put you in a position where you might be out of business.”

It would also be bad for the American people, she added, since studies like a recent Harris Interactive poll that found more than half of Americans couldn’t identify at least one of these terms: premium, deductible or copay, indicate the counsel of an employee benefit adviser is greatly needed.

Although she would most like to start from scratch with the ACA, Ayotte admits that repealing the president’s signature legislation is unlikely — even if Republicans were to win a majority in both the House and Senate in the midterm elections. Instead, she will focus on key areas of improvement, such as:

  • reinstating the 40-hour work week
  • improving provider networks
  • opening up the insurance markets across state lines
  • reinstating HSA deductions
  • repealing the medical device tax

Ayotte emphasized for a second time — to the sound of claps, cheers and whistles — the need to pass the MLR fix legislation. “[Congress must] make sure that we pass the legislation that ensures you can continue to do your business, to give people the service that they need,” she said. “Because if you go out of business, who will people turn to for advice? I think the administration really missed the boat on that one. They didn’t understand what you do.”

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