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March 21, 2013 at 09:41 AM
I think that the people in federal and state government agencies generally mean well and are in danger of getting into huge trouble if they’re too blunt.
Producers speak the language of clarity. Even if, occasionally, they are, arguably, wrong, they’re wrong in a clear way.
State government officials speak the language of “not getting fired due to excess clarity.”
This “Producers are from Mars/Officials are from the murky clouds of Venus” conflict came to mind this week as I’ve been working on a news feature about the role of producers in the world of Patient Protection and Affordable Care Act (PPACA) exchanges.
Health insurance agents and brokers are scared because the drafters of PPACA created “navigators” — ombudsmen who cannot get compensation from health insurers and are supposed to help consumers figure out how to use the exchanges.
In recent months, the U.S. Department of Health and Human Services (HHS) has created “in-person assisters” — people who are supposed help people sign up for exchange plans in person.
Now the State Health Reform Assistance Network is reporting that the Centers for Medicare & Medicaid Services (CMS) has created still another species of exchange helpers: “Certified application counselors.” The counselors will be “individuals in the community who are not paid directly by the exchange as official Navigators or [in-person assisters (IPAs)], but who are still helping consumers enroll in coverage through the Web portal.”
By the time the exchanges actually come to life, maybe there will be so many additional types of exchange helpers out there that naming them all will be akin to being able to name all of the Seven Dwarfs.
Producers have two main sets of objections to the talk about the various species of exchange helpers. One is that low compensation for the helpers could cut commercial insurance producers out of the game, and the other is that low compensation levels and weak helper qualification standards will lead to trouble for consumers.
The first concern has to do with producers misunderstanding the government officials, and the second with officials misunderstanding the producers.
What the officials are trying to hint, with wild gesticulations, without coming and out saying it, is that they can’t imagine producers who are used to working mainly with prudent, clear-minded consumers dealing with uninsured people.
Of course, some uninsured people are sane people who are uninsured simply because they’re broke, or because they have serious health problems that make getting through a medical underwriting process difficult.
