The exchange builders in the District of Columbia are wrestling with questions about how their Patient Protection and Affordable Care Act (PPACA) exchange should work with agents and brokers.
One question is whether an exchange should let licensed health insurance agents and brokers wait until they have actually sold an exchange policy from a particular insurer before getting an appointment with that insurer.
Another question that's come up is whether an exchange should care about "steerage"—intentional or unintentional efforts by brokers to steer consumers toward or away from certain plans—and, if so, how an exchange should try to prevent steerage.
Members of the producer advisory committee at the D.C. Health Benefit Exchange Authority, the agency in charge of setting up the DC Health Link exchange, talk about those questions in a report that could come up for consideration Thursday at an authority board meeting.
PPACA opponents have ramped up efforts to kill the law. If the work takes effect as written and works as backers expect, it will require federal and state agencies to have exchanges, or health insurance supermarkets, selling health insurance for individuals and small groups by Oct. 1, with the first coverage sold to take effect Jan. 1, 2014.
The District of Columbia is setting up its own district-based exchange.
The D.C. exchange authority has raised producer eyebrows by working to require all new individual health insurance sales to go through the exchange in 2014, and to eventually move all small-group sales onto the exchange. Brokers could still advise the employers, exchange officials have said.
But the producer advisory committee includes several producers and insurance company representatives, along with consumer representatives. And the facilitator is Janet Trautwein, the chief executive of the National Association of Health Underwriters (NAHU).
