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Life Health > Health Insurance

PPACA World 2017: Don Goldmann looks ahead

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Don Goldmann has two big roles in the commercial health insurance world remade by the Patient Protection and Affordable Care Act of 2010 (PPACA).

He’s the vice president of Word & Brown University, an affiliate of a general agency that helped create one of the first sturdy private health insurance exchange programs.

He’s also president of the National Association of Health Underwriters (NAHU).

In connection with the role at Word & Brown, he’s getting calls from colleagues with questions, or concerns about the newly implemented PPACA employer Form 1095-C coverage reporting requirements.

See also: Shan Fowler: The Day of the 1095-Cs

“There’s always the struggle the first time you do it,” Goldmann said. But he said many colleagues and employers have been recording the data they need to send out the forms since January 2015. The job is “a nuisance,” he said. But he said it also seems to be containable.

In connection with the NAHU role, Goldmann is getting another kind of call. ”We’re particularly getting a lot of questions about market stability,” Goldmann said today in an interview.

Callers want to know which insurers are going to sell what and where, and Goldmann is not sure what to tell them.

A review of early filings for 2017 shows that a unit of Cigna Corp. (NYSE:CI) might join the Virginia individual exchange market, but UnitedHealth Group Inc. (NYSE:UNH) seems likely to leave the Arkansas and Georgia individual markets.

Oregon seems to have at least 10 issuers showing an interest in selling plans through its state-based individual exchange in 2017, but there haven’t been any rate filings. Goldmann said he has no way to look directly at rate filings and depends mainly on carriers, analysts and other sources to tell him about plan supply. At this point, he said, “All bets are off.”

Managers of many of the surviving state-based PPACA exchanges have made significant progress in improving their overall operations, including their ability to support and pay agents, since the first open enrollment period in 2014. Also, the Centers for Medicare & Medicaid Services (CMS), the agency that runs and oversees all PPACA exchanges, is now much more open to getting input from NAHU and helping NAHU get information, according to Goldmann.

Before, “Washington didn’t understand that we represented brokers,” Goldmann said. Now, he said, policymakers understand that brokers speak for consumers, not the interests of the insurance companies.

The president of NAHU said his main current priority is persuading policymakers to find ways to keep the health market as stable as possible.

“You’ve got to stabilize the market for the consumer, stabilize it for the doctors and hospitals, and stabilize it for the insurance companies,” Goldmann said. “You can’t just leave them in the lurch.”

See also: 

5 more ways a Republican Congress could change PPACA

CBO: What if we shrink the group health tax break?


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