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NAIC: Consumer Reps See Widespread Confusion

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Many consumers are mystified by all of the talk about the Affordable Care Act.

The people assigned to represent consumer interests in the proceedings of the National Association of Insurance Commissioners (NAIC), Kansas City, Mo., make that case in position papers posted on the NAIC/Consumer Liaison Committee section of the NAIC’s website.

The consumer representatives posted the papers in time for the NAIC’s fall meeting in Orlando, Fla.

The consumer reps also were talking about issues such as retained asset accounts and efforts to return abandoned insurance funds, but implementation of the Affordable Care Act — the federal legislative package that includes the Patient Protection and Affordable Care Act (PPACA) — inspired a majority of the positions papers and other documents posted by the NAIC/Consumer Liaison Committee.

Republicans say their surveys show many Americans oppose the Affordable Care Act.

The NAIC consumer reps say they believe surveys and press reports have documented widespread public confusion about just how the act might affect private health insurance. Groups that work with consumers have encountered the same kind of confusion, the consumer reps say.

Much of the confusion stems from misundertandings about what is in the Affordable Care Act, when the provisions will take effect, and what terms such as “annual limits” and “lifetime limits” mean, the consumer reps say.

In some cases, the consumer reps report, consumer beliefs about the act are wildly off the mark. The reps say act supporters should directly address myths about the Affordable Care Act.

“For example,” the reps suggest, “the myth that it requires people who want public insurance to be implanted with a microchip.”

The best way to spread accurate information and correct myths is to get accurate information to community leaders and community institutions that consumers already trust, the reps say.

In another document, the reps talk about the “navigators” who are supposed to help consumers understand the new health insurance distribution exchanges that are could be up and running by 2014. The Affordable Care Act calls for the government to use the exchanges to provide subsidies that individuals and small businesses can use to buy high-quality health coverage.

Health insurance agents and brokers say producers are the ones who help consumers and small business owners make sense of the current health coverage system.

The NAIC has argued that the people helping consumers analyze health insurance options ought to

be licensed as health insurance agents or brokers.

The consumer reps say they disagree with that approach.

“The producers are making the case that they provide a vital service in the current system, and further, they believe the navigators envisioned in the bill should be built upon the existing infrastructure of insurance brokers and agents,” the consumer reps say. “As representatives of consumers and workers, we recognize the important role that brokers and agents have played in the existing system. However, going forward, we need to think anew about what the navigators’ role should be in the context of the broader reforms.”

The consumer reps say they would like to see the navigators have a fresh perspective and not be an “imposition of the old upon the new.”

“Navigators must have knowledge of the entire marketplace within the exchanges, not just knowledge of commercial insurance products,” the reps say. “They should be compensated on the quality of information they provide, not on volume. We are concerned that there is the potential for abuse or fraud, and therefore, we would support some form of credentialing and performance review of the entities engaged in providing navigator services.However, we believe it would be inappropriate and contrary to the intent of the statute to require licensing as is currently done for brokers and agents.”

The consumer reps say the navigators should be paid in a “manner that does not create incentives to encourage or discourage certain consumer behavior or preferences.”


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