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
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
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