Paying agents and brokers who work with the new health insurance exchanges fairly could protect the exchanges against adverse selection, according to C.M. Gallaher, a vice president at America’s Health Insurance Plans.
AHIP, Washington, is one of a number of health insurance groups, health insurers, business groups, provider groups and consumer groups that have submitted comments on draft papers posted by the Exchanges Subgroup at the National Association of Insurance Commissioners (NAIC), Kansas City, Mo.
The federal Protection and Affordable Care Act (PPACA) is supposed to create the health insurance exchange system in 2014.
Republicans are trying to block implementation of the act.
If the health insurance exchange provision and related provisions take effect as written, the exchanges will help individuals, families and small groups buy commercial health coverage using new system of tax credits. PPACA will require carriers to sell the coverage on a guaranteed-issued basis, without taking health status into account when they are setting prices.
Nonprofit advisors called “Navigators” who receive no compensation from health insurers are supposed to help consumers use the health insurance exchanges.
The authors of the Exchanges Subgroup drafts have dealt with the role of producers and Navigators in an exchange system; strategies for preventing adverse selection; and ideas for financing the exchange.
What Will Producers Do?
Even commenters who are skeptical about agents and brokers, such as the NAIC consumer representatives, say in their letters that they believe producers will continue to play an important role in the health care system.
The consumer representatives are professors, patient advocacy group representatives and others who receive funding from the NAIC to represent consumer interests in NAIC proceedings.
“Producers will continue to play a role in assisting small employers and their employees navigate the exchange and will continue to offer their services in the nongroup market as well,” the consumer reps say.
Similarly, a group of progressive group commenters led by Cheryl Fish-Parcham of Families USA, Boston, says, “We agre that producers will play a crucial role in the success or failure of an exchange.”
But the NAIC consumer reps argued that the new Navigators need not be health insurance