CapCon 2011

Day 3 of Cap Con 2011 began with another 3 hour “mega” general session. We had more congressional representatives who spoke with us and I can say that I am even more convinced that we have support for agents and brokers, as a part of the delivery process for healthcare reform, on the Hill.
Rob Andrews, a NJ Representative started things off and was a good speaker. He was very honest with us and noted that he does not believe PPACA will be repealed. He noted there were 4 major points he wanted to make today;
1. That he believes that agents and brokers should be a part of the delivery system.
2. That our services do not add cost as much as value, and as such, our fees and commissions should be counted in MLR.
3. The small business tax credit needed to be “cleaned up”. He noted that, currently, spouses and children of business owners are not counted and need to be. He did make appoint that resonated with me. He noted that this encourages small business owners to not think about hiring family, but looking to others when thinking about expanding. I could see how some small business owners could find this troublesome.
4. (This was his most emphatic point) That patient responsibility needs to be better addressed in PPACA. Rep Andrews believes that this is the number one drive of rising healthcare costs.
He left us with an interesting statement. He wondered how countries such as Egypt and Tunisia are faring as they struggle to keep people from fleeing their countries, while we here have to deal with the problem of too many people trying to get in. He stated this is still the number 1 economy, healthcare system and place for education in the world. We still have much going for us and we should remember that.
Next up was Richard Popper, a Deputy Director at HHS who is charged with the formation and promulgation of high risk pools to insure those with pre-existing conditions who cannot obtain coverage. Again, our speaker was honest with us and went to the edge on a few answers in the interest of honesty. I really like it when people take the tough questions and respond with answers that may not win them popularity contests, but know that the answers need to be said. Richard educated us on the formation of Pre-existing Condition Insurance Plans (PCIP’s) and noted that about 27 states opted to create their own PCIP’s while the other 23 are using a federal PCIP. If you want to see which states are doing what, go to www.pcip.gov. Two interesting items to note were, of the 27 states that opted for their own PCIP, 25 are paying some form of compensation to agents and brokers for helping guide folks through the system. I believe New York is one of the 2 that do not compensate agents and brokers for helping folks connect to the PCIP. The second item was his response when he was asked if the federal PCIP was subject to the same MLR that other carriers are and he answered (honestly) no. The crowd was visibly upset and he did go on to state that most high risk pools run with MLR’s in excess of 160% and that MLR was not really necessary. I thought if it was not, why wouldn’t they obligate themselves just to show that the government is willing to play by the same rules it dictates. Interesting.
Next up was the first of two senators who spoke with us. I was interested to hear what they had to say since the House clearly is not happy with PPACA but the senate is still pushing forward with it. Mike Enzi from Wyoming was the first up. Next up was Mark Begich. I put these two presenters together because they each did not say much. My guess is that they know there is no senate support for PPACA repeal and to go out and take a stand against it may not help them, so I think they both played it safe. Both did express their concern, but were not specific about solutions. Sen. Begich did say, quite frankly, that he felt the Senate failed on cost-containment and admitted they have to work on that. I guess you can say I got the answer to my “where’s the savings?” question.
The last speaker was a good one. Karen Harnet (again, I may have the last name wrong or misspelled it as she was not on the list) is the Counsel for the National Federation of Independent Business (NFIB) and she is heading up the NFIB’s fight to rule the individual mandate unconstitutional. She was very good at giving us the legal update on where this is without losing us in the technicalities. Generally speaking, the thrust of the argument is that, while Congress is charged with regulating commerce, it cannot compel individuals to engage in it. The NFIB (along with 26 states) feel that Congress overstepped their bounds. There was some discussion of district circuits and upcoming decisions, but what struck me is that 26 states are more than half our country. There are those who believe that the individual mandate is the lynch pin for the entire PPACA and if that is ruled unconstitutional, the entire bill is in jeopardy. What I took that to mean is that, over half our nation believes that this law is not good (at best) and even want to undo everything that has happened since last march and start all over again (at worst). I have always felt reform was needed, and am nervous about going back to square one in this economy. I also think there are several aspects of the act that do not make sense and are actually counterproductive to healthcare reform, so I am not sure whether to wish for repeal or not.
Anyway, I am done with my legislative meetings so that is it for now. I have asked all those from our state that had meetings to send me a briefing about their meetings so I can share them with you. I’ll post more on the blog as soon as I hear back. I want to thank all those who participated and shared their information with me. A special Thanks to Mickey Lyons, Jeanette Jones and Maureen Pelose for making more than their fair share of meetings. It is good to have folks like this in our association.
Feel free to post your comments and feedback.
All the best to all of us.
Pete