Yesterday, I continued trying to give the best answers I could come up with for the agents, brokers and others who are asking me for advice about how to become a Patient Protection and Affordable Care Act (PPACA) exchange navigator, an exchange-certified producer, or some other person who helps individuals or employers make their way through PPACA World.
Here’s a fourth (and, for now, last) batch of answers.
If I went to work as some kind of exchange helper, how would I find people who need coverage, would be reasonably easy to enroll, and would be willing and able to pay whatever their out-of-pocket share of the cost would be?
Answering that question might help determine whether it makes sense for you to get involved with the exchanges or not.
If, naturally, you hardly ever run into the poor uninsured people who would qualify for generous subsidies, or the high-income uninsured people who would be happy to pay the fairly high unsubsidized cost of the coverage, you may find that taking the trouble to get certified as an exchange broker would be, at best, a frill.
But, if you think hard and ask questions, you might find that there are uninsured, or very poorly insured, people all around you.
Many free-lancers and consultants, for example, have no health insurance or terrible health insurance.
If you’re in New York, a state that already offers coverage on a guaranteed-issue basis, you might find that most of the people with health problems who can afford unsubsidized coverage already have coverage. But, even there, some people with incomes that are “high” by national standards, but low by New York standards, will discover that they at least have an easier time buying relatively stingy bronze coverage.
In a state like California that allows medical underwriting, you may find that many high-income people with health problems have been shut out of the commercial health insurance market and will be happy to pay a high price for decent coverage.
Why are you trying to further the evil that is the PPACA exchange by giving people ideas about how to work with the exchange?
On the one hand, different readers have different ideas about what’s good and what’s bad.
Some, for example, view Barbie movies as a grave menace. Other people are 7-year-old girls.
On the other hand, if you really, really loathe the exchanges and read about how to work with the exchanges, maybe you’ll come up with creative new ideas about how to thwart the exchanges.
On the third hand, if you despise the exchanges, maybe you could tinker with some of the suggestions I came up with here and adapt them for creating and marketing anti-PPACA programs, such as health care sharing ministry or Native American plan programs.