On the Third Hand: Not heaven

I wrote a news article last week about the efforts of the managers of Colorado’s state-based health insurance exchange, Connect for Health Colorado, to reach out to brokers.

Starting a Patient Protection and Affordable Care Act (PPACA) state-based exchange is really hard. The managers have had to do their work quickly, in a complicated regulatory environment, in the face of conflicting and constantly changing demands from Washington and state capitals.

It’s hard for a reporter to tell whether they have too little, too much or just the right amount of funding, but it seems as if the amount of funding they can actually get, or use for specific tasks, is uncertain.

And one of the reasons health insurers generally welcomed the idea of the government setting up an exchange system is that, over the years, the pioneers that tried to do the job without government help ended up with many arrows in their backs.

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So, on the one hand, I think that, whatever one thinks about PPACA as a whole, or the PPACA public exchange system as a whole, it’s reasonable for reporters to have pity on the human beings struggling to set up and run the exchanges. My instinct is to cover exchanges with operational problems based more on how well the exchange managers disclose and make efforts to fix the problems than on whether they have problems.

But, on the other hand, agents, brokers, insurers and consumers are stuck with actually trying to use the public exchange system, and many focus pretty intently on whether the exchange, or exchanges, they use actually work. This is especially true this year, now that the second PPACA open enrollment period and the various extra wiggle room enrollment periods have ended.

Brokers from all over the country responded to my Colorado exchange article, which had the headline “How to get brokers to love you,” that they might love the exchanges a lot more if the exchanges would make some effort to help them get the miserably low commission payments they’re owed.

Brokers suggested that getting the #%2@#$ed !#@$!%ing websites to work properly would also help.

One broker in Colorado, for example, told me that the new PPACA medical underwriting restrictions and exchange system have tripled the amount of individual health insurance he writes.

He still runs into an occasional problem when he writes coverage by working directly with a carrier. He may face some kind of glitch about 10 percent of the time, and a big underwriting problem once every 15 to 20 sales. But he thinks the level of glitches in that channel is similar to what it was before PPACA came along.

When he sold public exchange coverage during the 2015 open enrollment period, he had to call the exchange or the carrier about one-half of the time, and he ended up having to make several calls over the course of about a week about 25 percent of the time.