Recap of July 2009 NAHU Fly-in

My day started at 7 a.m. as I rode up to the Grand Hyatt to meet up with over 1000 other insurance agents and brokers to begin the day. It was an impressive sight to see that many of us all in one room, with one agenda. Today’s mission was to make our voices heard on the Hill. I’m sure our voices were heard as I could not turn a corner in any of the House office buildings and not see a group of others wearing the same name badge as me.

As many of you already know, both the House and the Senate have legislation drafted to address the president’s order for healthcare reform. All my meetings today were on the House side, so my blog will be focused on that piece of legislation. The House bill is over 1000 pages long (the summary is over 40 pages). I will tell you right now that no legislative director, or assistant, we met with today had read the bill and admitted to that fact. I took three meetings today- Rep. Tonko’s office, Rep. Arcuri’s office and Rep. McCarthy’s office. All the meetings had at least three of us and the last two had almost 10 each time.

As we did when I was here for the Cap Con, we stated that we were exited about healthcare reform and wanted to let the representatives know that NAHU members deal with public everyday and assist them in navigating through plans, policies and pricing mechanisms. As such we wanted to offer our assistance as a resource to help them create reform that has the best possible chance of success when it hits the ground.

It is hard to see where this will go at this moment. Mark-ups on the bill (the process by which parts are added, deleted and/or changed) began as I was exiting the buildings. While I cannot tell you what the final product will be, I will give you an overview of what we discussed and were we stand on some of the key elements of the House Bill.

· Market reform- The House bill will ask for a federal policy that will allow for a health plan that will be guaranteed issue and will not have pre-existing condition exclusions. NAHU supports this as well as no health status rating. In addition, NAHU feels that any market reform should allow for experience raring to continue for groups over 50.
· Minimum Loss Ratios- The house bill asks that carriers maintain at least an 85% Medical Loss ratio and if non-claims cost exceed 15%, then rebates be issued to policy holders. NAHU opposes the imposing of minimum MLR as they feel that not all cost associated with running health plan can be neatly placed neatly into MLR or admin categories.
· Creation of an Exchange- the House bill proposes the creation on an exchange where individuals can purchase healthcare coverage. A new federal agency, the Health Choices Administration would oversee the implementation of the exchange. The idea is that Medicare reimbursement rates would be the reimbursement method for the first three years, and then claims data would be utilized to create different ones. The idea is to first allow individuals, then employees, to enroll so that within 5 years, all Americans could have access to coverage through the exchange. While NAHU believes that an exchange is not needed if effective market reforms are enacted, we do recognize Congress’s commitment to this and would ask that each state be able to create it own exchange as plans, risk and affordability vary greatly from state to state.
· Essential benefits- the House bill suggest that the Health Choices Administration determine a minimum benefit plan that will be the ‘benchmark” plan within exchanges. NAHU supports this and we believe there is a need for this and it is essential to healthcare reform.
· Agent Provisions- The only mention of this in the bill looks to be that the Health Choice Administration will set uniform marketing standards for all entities offering exchange plans. NAHU strongly recommended the use of the existing broker and agent network to help facilitate enrollment, assist in coverage choice and help with eligibility determination. Our role here is crucial to the success of any plan that could cause a transition in health plans.
· Creation of a new Gov’t Run Public Plan Option- The bill would allow for a Gov't run option to be crated to compete with the private market. All Medicare providers will be forced to participate for 5 years, and then others will be encouraged to join. The plan will start with unlimited Gov’t funds but eventually have to be self-sustaining. No surprise here, we are opposed to a Gov’t run plan option. The Gov’t cannot create the level playing field needed to not adversely affect the private market. It would displace millions of Americans and cause more chaos than good.

As I mentioned, the House bill is over 1000 pages and there are way more items than what is mentioned here. Sorry there was not more “this rep said this and that rep said that”. Everyone noted they were aware of the bill and had not read it and, therefore, could not agree or disagree with our suggestions. The bottom line is we were there, in force, and let the people on the hill know that we know our clients, we know our business and we can help.

I’ll try to get the Senate bill broken down for you all in my next blog. Stayed tuned, and stay active, these are very important times for all of us.

Pete

Last Day of the 2009 Capitol Conference

The last day of the Capitol Conference went well. Another 3 ½ hour general session that featured 4 Representatives and 1 Senator. The lone Senator was Orrin Hatch (R-UT). Senator Hatch was well spoken and supports our efforts. He clearly does not want a single payor system. He noted that the Senate is looking to pass healthcare reform under a budget reconciliation process whereby the discussion is limited to 20 hours, no language can be added and it only takes a simple majority (51) to pass. Senator Hatch feels we should not push so quickly, and with so little majority, on something that represents 1/6th of the entire federal budget.

Sher Sparano (NYC NAHU member) and I met with Tiffany Guarascio, Senior Legislative Assistant to Congressman Anthony Weiner who gave us an interested spin on this. While she noted there were short-comings to the budget reconciliation process (BTW- she told us the House does not have something like this) she felt that 20 hours of debate is long time (on the hill) and the regular process (the name escapes me) allows for a few Senators to hold out and stall the whole process. I believe this is what happened with the President’s initial stimulus bill. Not sure which is better or worse? We do need reform, but at what expense? Our meeting with Tiffany lasted ½ hour and she asked questions and gave us some insight into what’s going on. She noted that single payor did not look to have any legs at all.

We had two other House meetings today. One with Eli Kogan, Senior Legislative Assistant to Congressman Joseph Crowley and another with Becky Cornell, Legislative Aide to Congressman Paul Tonko. The meeting with Eli was very short. He took our material, heard what we had to say and thanked us for coming. Becky took lots of notes and could only tell us that Mr. Tonko supports universal access. Becky did know who NAHU was and said some legislative people from NAHU had been by to brief them. This was the first meeting we had where they noted they knew NAHU.

Yesterday we met with Meghan Taira, Legislative Assistant to Senator Schumer. There were 5 of us who met with her and she told us they were busy trying to conceptualize a Public Plan Option. This was new phrase for me and she note this would be the government provided plan that looks to be passed before August. Today we heard both Senator Hatch and other House Representatives mention this same phrase. Meghan told us that no language has been drafted, but this is what they are working on. We told her that while we were not opposed to a plan (like the Public Plan Option) to back up any individual coverage mandates, we felt that a level playing field was critical to the survival of the private market.

This is a big issue folks. This looks to be what the new government plan will be. After our Schumer meeting we all discussed how we could see each state selling this as the state’s PPO option (sound familiar?) We felt this would confuse folks in the market who are familiar with PPO’s in the private market, but not aware of how this applies under a federal mandated plan. They may gravitate to this plan not knowing what it really is. Combine this concept (which has familiarity on the House side) with a “get it done before the August recess” mindset and it’s not too hard to see why Senator Hatch feels that the Public Plan Option is the long road to a single payor system.

Mr. Hatch told us this is the year to convince congress that our ideas of reform will have a positive affect on healthcare. All of us at the Capitol Conference got the feeling from both houses of congress that they are acting fast and want to deliver something to the President soon. We need to be aware of what’s going on and stay in touch with our legislators and stay atop of what our national organization is doing on our behalf.

That’s it for the 2009 CapCon! I hope you all enjoyed reading my updates. We’ll work to continue the blog to keep folks up to date and share ideas. To my wife (who I know has been reading my blog) - Honey, I’m coming home!

Very Important Meeting on "The Hill"

As you can see we had great meetings on our first lobbying day.

Today started with a marathon general session that went from 8 a.m. until 11:30 a.m. We were addressed by a couple of legislators, a Whitehouse budget representative, a healthcare CEO and finally a panel presentation consisting of two gentlemen from the provider side.

At this point, I’ve been eating, sleeping and breathing healthcare reform since Sunday so I did not take as much of that message from today as I did the little things that were said. Here’s what I got from today;

Our first speaker was Senator Ben Nelson (D-NE). Senator Nelson supports our position, but it was his first comment that struck me a funny. He noted that it used to be when a representative in Washington, after being introduced, would always say, “Thanks a million”. But in today’s Washington, he said, it’s more like, “thanks a trillion”. This was funny, but a little scary. I’m reminded of what one of my teachers said, “Many a true things are said in jest”.

Our second speaker was Keith Fultonol (I may have misspelled his last name) who is the Associate Director of the Office of Management and Budget (http://www.whitehouse.gov/omb/budget/). Keith went over the President’s budget regarding healthcare (FYI President Obama has put in $634B for healthcare reform). He laid out the President’s agenda for healthcare reform that includes guaranteeing individuals access to Doc’s, increasing the quality of care, decreasing cost and eliminating barriers to continuing coverage between jobs (among other things). While most yawned through his presentation that included slides of massive spreadsheets that you could not read (even on the super large 20’ screens), I enjoyed this presentation the most out of all of them. I like the numbers.

Next up was Don Hamm, President & CEO of Assurant Health. Don is also on the board of AHIP and presented their position on healthcare reform. AHIP’s position is to allow guaranteed access to coverage (with no Pre-x) and would like to see a sliding scale subsidy for those living between 100% and 400% of the federal poverty level (FPL). What I found particularly interesting is that Don broke down the uninsured numbers for us. 48MM uninsured works out to be 9MM non-resident Americans, 15MM who are insurable but who choose not to purchase coverage and above 400% of FPL, 22MM living between 0% and 400% of the FPL and 2MM who are uninsurable.

Then came Representative Allyson Schwartz (D-PA) who supports us, but was not versed in the recent COBRA stimulus package. Unfortunately these were exactly the questions that came from the audience and, after a couple of tries, scooted off the stage and thanked us for having her.

Then came the panel of providers. I have to admit here folks, they started with similar support statements and I had had enough (and still had an April renewal to secure) so I scooted too. Sorry, nothing to note here (other than I took care of my renewal).

We did have one legislative meeting with Senator Schumer’s Legislative Assistant, Meghan Taira, but I will blog about all our legislative meetings tomorrow after they are all completed. You’ll have to read about this then.

Day One of 2009 NAHU Capitol Conference

A great start to the 2009 Capitol Conference. The first general session started with a recorded presentation of the story of the Star Spangled Banner, followed by the song. I’m a fan of history and enjoyed being reminded of how our nation overcame great adversity & odds. The rest of the session focused on our national legislative priorities and a review of those issues we feel are “draw a line in the sand” issues and what ones we support, but with great caution and instruction.

Our regional break-out session was informative as Charlie Gartlan, current region 1&2 RVP, introduced Norman Michaels, our upcoming Region 1 RVP. Regions 1&2 are being split and Charlie will lead Region 2 and Norman will lead Region 1 (which includes NYS). Norm has risen very quickly in the NAHU ranks and is excited to be working with us all.

Most of the NYS contingent gathered after our regional meeting for a group photo. Check us out.

I attended two afternoon sessions on Pools, Connectors & Exchanges and, let me tell you folks, it was a little more complicated than I had thought (maybe because it was after lunch). I need to do more research before I can tell you about it here.

The last general session was quite informative as we were joined by Representative Steve King (R-IA) who put some interesting recent events together for us. We know that the Federal Government has now bailed out banks and Wall Street. We also know that the Government has “helped out” the Auto Industry. Today CNN reported that the Government is calling for the job of the head of GM (in other words- fired) and is instructing Chrysler to merge with Fiat. Mr. King is worried about the nationalization of a great many previously market-driven industries. I must admit this worries me too.

Now, more than ever, we need to prove our worth to our clients. As I mentioned before, we are in a unique position as we speak both to the insurance industry and to our clients. I urge you all to re-dedicate yourself to our industry and to your clients. Continue to help strive for a fair position where the company is there for our clients and our clients know what is expected of them. The concept of a nationalized healthcare system is most certainly not out of the question for a government that is already proven it will “call the shots” in other areas we never thought possible. These are new times.

I’ll leave you with one quote shared with us here in DC at the end of our day (from Albert Einstein) - We cannot use the same thought process to solve a problem that we used to create it.

Talk to you all tomorrow.

Pre Conference Leadership Forum

Today I was in the (pre-conference) Leadership Forum from 8:00 a.m. until 4:45 p.m. The featured Speaker was Bryan Dodge, author of The Good Life Rules: 8 Keys to Being Your Best at Work and at Play. To check him out go to http://www.bryandodge.com/. Bryan broke a personal rule to never speak on a Sunday to speak to us. His father was in this business and he feels an alliance to what we do. Word on the street is that NAHU will have the presentation available on the web site- so keep an eye out for it.

We also got an opportunity to meet Russ Childers, NAHU’s President Elect. As you can see, I got a chance to meet Russ too (check out the picture). Russ was very welcoming as he addressed the group of roughly 120 of us and made us aware of some interesting statistics:

• There are exactly 18,735 members of NAHU.
• There are 220 state and local chapters.
• The average age of a NAHU member is 46 (while the industry overall is 56).
• Our membership is 50% male and 50% female.
  

Russ noted that NAHU has never seen a more motivated Congress than this one and there are aggressive reform goals being discussed on "The Hill”. He noted that some Legislators are pushing for a healthcare reform package to be implemented before the August recess. No doubt folks, this Congress is focused so it is more important than ever that we also stay focused on our message of helping to shape a healthcare system that is not just affordable, but is also accessible and transparent.

Carol Matznick, NAHU Chapter Relations Chair, went over the NAHU organizational structure and also reviewed all the resources available to the chapters through NAHU’s web site. Very good stuff!

The lunch session featured three NAHU Chapter veterans who shared information about increasing membership, education and volunteer action. This was a good Q&A session and I’ve taken notes, but won’t bore you all with them here and now.

The things that Russ and Carol shared will certainly help our chapter. The things Bryan shared will also help me. I will share this thought from Bryan; the key to building an effective association is based on our ability to get others to work with us.

Stay tuned…tomorrow's the start of the 19th NAHU Capitol Conference.

Getting Ready for the Capitol Conference

It’s Saturday afternoon and I wanted to let everyone know that I arrived safe and sound. It’s colder and cloudier than Albany (imagine that!). Cherry Blossoms are in bloom though. I spent some time Friday gathering data and reviewing our positions on various national legislative issues. I am honored to be here on behalf of our local (and state) chapter. I had my first chance to lobby several years back when the Sole Proprietor Legislation was being formed and I got a glimpse of how important it is that we stay aware of issues and interact with our representatives on the state and national level.

Our membership is in a unique position to affect healthcare reform as we are, in a way, bilingual, in that we speak both “insurance speak” and “client speak”. We know our industry and we know our clients. We have an obligation to our clients (and our industry) to help shape a healthcare system that promotes wellness, efficiency and affordability.

Enough of the niceties, I also want to make those of you aware of where NAHU stands on national legislative issues. To view the NAHU 2009 Legislative Priorities, click HERE.

I think the first step we should take is familiarizing ourselves with these priorities. The second step is getting familiar with the legislative process. I’ve found visiting the congressional web sites very helpful in figuring out it all happens. I am embarrassed to say that, until only a few years ago, I was not aware of much of this (I should have paid more attention in my Political Science classes).

Anyway, the two sites to visit are the Senate web site and the House of Representatives web site. Go to http://www.senate.gov/ to research Senators, committees and other items of interest on the Senate side (see if you can find out why Schumer is a Class III Senator while Gillibrand is a Class I).

As you know we only get 2 Senators, but get 29 House Representatives. Go to http://www.house.gov/ to see who your representative is as well as see what’s going on in “The House”. Our New York contingent will most likely visit our 2 Senators as a group, but I will be meeting with my particular House Representative, Paul Tonko, with only a couple of other NYSAHU members.

That’s it for now. Tomorrow starts at 7:30 a.m. and I’m in the Leadership Forum until 5 p.m. I hope to be able to at least “Twitter” quick updates, but if not you’ll hear my thoughts here after it’s done.

Take care,

Pete

WELCOME

Welcome to the New York State Association of Health Underwriters new blog site! In order to effectively communicate with our members, and give them a voice to communicate with us, we have established this site. Now it is up to you to tell us how you feel!

Peter Andrew, NENYAHU Treasurer, has agreed to be our first blogger. Peter will be attending the NAHU Capitol Conference in Washington and providing us with daily updates with what is happening. Thank you for sharing Peter!

NYSAHU has several representatives attending this key event to meet with members of Congress to discuss NAHU's positions. This year's conference is entitled "One Mission, One Voice: Working Together for the Future of American Health Care".

Welcome again! Please send us your comments!

Barbara