How do brokers feel about the Affordable Care Act? Overwhelmingly negative, new research shows. Eighty percent of the 1,028 brokers surveyed by Benefitter gave unfavorable feedback about the health care law.

Rate increases was the top concern reported to the San Francisco-based technology solutions company. Benefitter asked brokers to answer an open-ended question: What do you want your legislators to know about the ACA?

“We had 50 single-spaced pages of feedback,” Benefitter CEO Brian Poger says. “Not surprisingly, brokers are concerned about their clients. They’re concerned about their livelihood.”

Other top concerns brokers reported included:

•       Increased complexity

•       Reduced role of the broker

•       Diminished plan quality

•       Other law nuances like website malfunctions, the uneven expansion of Medicaid and confusion over grandmothering

•       Employers dropping group benefits and transitioning employees to the individual market

•       Compressed timeline

Also see: 7 concerns brokers have with the ACA

Cost and complexity are two themes that standout to Ed Oleksiak, the national legislative council chair for the National Association of Health Underwriters. Navigating health care has become more of a burden for employers since the ACA passed, Oleksiak says: “How do you stay on top of everything?”

Despite competing for the same clients, Oleksiak says, brokers have been working together to help one another understand the ACA. “It’s constantly changing,” he says.

That complexity has made brokers even more essential, says Oleksiak, even though some in the industry feel their role has decreased due to the ACA. “It’s made us more valuable,” he says. “We have an expertise in this area.”

Brokers losing patience

Implementing the new health care law is a massive challenge for the Department of Health and Human Services. But as the months pass and problems persist, brokers are starting to lose their patience, says Wes Bissett, senior counsel, government affairs for the Independent Insurance Agents and Brokers of America, Inc. “Hopefully by year three we’ll see some improvements,” he says.

Foundational issues with the exchanges must be improved, he says. One example is the way the federal exchange is set up. Bissett says brokers essentially need to be side-by-side with a client during the selection process. “It’s like moving mountains to make a basic change to a selection,” he says. “They make it hard for agents to help consumers and clients.”

A portal that connects consumers with brokers would fix the latter issue, Bissett says. Brokers also want to hear a long-term plan for the exchanges, he says. Despite the challenges that remain, Bissett is optimistic. “We’re hopeful. We want this to work,” he says. “We’ve got some progress to make, though.”

A changing industry

If you ask brokers what the industry will look like in 10 years, Poger says they’ll have three responses: Employers will stay with their group plan, some will move to a private exchange and others will go to a public exchange. The problem, Poger says, is that most brokers — less than 10% — don’t have a strategy for helping employers move to the public exchanges. “It’s a massive, massive change,” he says, and one brokers need to be prepared for.

“These guys are incredibly savvy and powerful and helpful, but time is moving faster,” Poger adds. “You’re going to see more and more left behind if they don’t get in front of it.”

Most who shift to the individual market will be small businesses that are exempt from the employer mandate, Poger says. Providing health care to employees and their families isn’t possible for many small employers, he says, making public exchanges a good option.

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