CapCon 2011

As I mentioned yesterday, it’s a different world for healthcare reform and this year's Cap Con began to reflect that. Last year's general sessions were chock-full of Representatives talking about their stance on healthcare reform, their opinions on how reform should be and what should go in the bill. This morning’s general session included three senior legislative staffers giving their opinions on healthcare reform and how we should conduct ourselves in our legislative meetings. To be honest, their advice and presentations were pretty much familiar. There were two interesting things to note in this general session. One of the presenters John Williams noted that the average age of a congressional staffer 25 years old. This puts the average congressional staffer in the category of “young invincible” with respect to healthcare. What's interesting here is most people know that although there Congressman or Congresswoman does actually cast the “vote” and certainly are aware of the issues. But we need to be aware that congressional representatives and senators rely on staff to make them aware of situations and advise them on certain issues. It is interesting to me that healthcare reform and the future of healthcare is being assisted by and advised by those who have little familiarity with healthcare utilization.
The second interesting thing about this session was during the Q&A session. John Williams was asked how he selected his health insurance plan as a congressional employee. This question was met with the rowdy laugh and applause from the audience. He noted that he read a “booklet” put together by the human resources department that standardizes the offerings available to him and he chose a plan based upon what he thought was the best choice for himself and his family. What I found interesting here was that John has access to (what I would say is) a pretty well-heeled human resources department who probably put together a nice explanation of what benefits are available to him and how they stack up to other options. What it made me wonder was how does the small employer provide their employees with benefit communications? I believe herein lies the value of the agent. I believe the value of an agent to the employer can be different from large employers to small employers. I think large employers rely on an agent or broker to be a good negotiator. Think small employers rely on an agent or broker to be a good communicator. For small employers, it is usually the agent or broker who is holding the enrollment meetings for employees and explaining coverage so that they can make their choices. Can we really expect busy people to read more about such complex issues in order to save 3-5%? I think they would gladly pay it to have someone to help them.
After the general session we had our regional meeting with our VP, Norm Michael's. Norm noted that our region had the highest Cap Con attendance that we've ever seen. Mickey Lyons, a previous New York State AHU president, noted that New York State had more congressional meetings scheduled than we ever had as well. It was good to hear that during these very tumultuous times agents and brokers are stepping up taking an active role in their industry. Our members here are not just striving to preserve their role but trying to preserve all agents and brokers roles. Our region is divided up into several states Norm invited each state to give a legislative update on what each state has been doing with respect to healthcare reform and share some of the challenges that they have had over the past year. The folks from Massachusetts had the most to say. I would've expected that. One particular note that I found interesting was that in Massachusetts they set MLR at 88%. The question I posed to the representatives from Massachusetts was that, in light of the exchange program the Massachusetts and an 88% MLR, how are agents in Massachusetts surviving? The answer was we are resilient. There you have it; we are resilient. I believe agents and brokers bring a value to healthcare system. Massachusetts brokers would have gone away if employers did not value them. We may need to change the way we do business and our brothers and sisters in Massachusetts are leading the way.
In the afternoon I attended the first of a two part session on exchanges. The format of these one-hour sessions was one half hour of presentation and one half hour of Q&A posed to a panel. The presentation part was extremely helpful as NAHU staff and others gave tips on what they thought exchanges would be and what we as agents can do to prepare for them. Now keep in mind that exchanges probably make the broker community more nervous than any other aspect of the PPACA, but exchanges will not be of effective until 2014 so there is much to be considered and there are many different forms that exchanges could take between now and then. The best advice that was given to the membership was that we is agents should familiarize ourselves with as many existing exchanges as there are. As you know, each state looking to form exchanges will most likely look to existing ones when creating and developing their own. Massachusetts, as you know, is probably the most well known exchange. However the state of Utah has also created an exchange program and Wisconsin has begun a prototype. The advice of the panelist were that NAHU members should visit these websites familiarize themselves with the navigation tools on the sites. The Massachusetts exchange can be found at www.mahealthconnector.org and the Utah exchange can be found www.exchange.utah.gov. Take a look when you get some time. The second half of the session was a Q&A for the panelist and I have to say I could sense the frustration of the broker community in the questions that came.
The second part of the exchange breakout session was not as exciting since the formation of exchanges is speculative at this point. The panelist did a great job at laying out the options and the members ask questions however, many answers were “we’re not sure”, “we don't know” or “we’ll have to wait and see”. One particular member posed the question that Massachusetts, which is really the oldest exchange example, has not fared well and what is NAHU doing to hold that as an example of not how to do things. That question was met with a round of applause from the audience. The panelist did their best to answer it, but again where not sure. Each state makes its own decision as to how to structure and manage and regulate their exchange.
The last session I attended was the final general session of the day. The format of the general session was a town hall meeting to discuss member questions and concerns prior to their Capitol Hill visits. After a brief presentation of the panel, the floor was opened up to questions from the over 700 NAHU participants. Janet Trautwien was surprised (as I was) that the line at the microphone was not as long as we might have expected. I think that speaks volumes. We spent a lot of energy and a lot of resources getting to know PPACA, fighting against certain aspects of that act and understanding the ramifications after it was passed. We also spent a lot of time communicating with our clients over the past year and we might be a little tired. But we can't give up. I Believe customers and clients in the public are starting to see all of the different aspects of this act and that, as a combined piece of legislation, there is much to be desired.
Now is when we will be needed to advise those who are charged with implementing this facets of the law and I believe they will be grateful for our help and assistance and we can prove our value to them like we do to our clients every day. Take a break if you must, but come right back and help because we need to do more.
BTW- I did ask three different conference participants about how this act was going to lower health-care premiums. Every single one of them shook their head had no answer for me. I don't know if I'm going to get a different answer on the Hill tomorrow but you bet I’ll asked that question.
Talk with you all tomorrow.