The suspension of efforts to get H.R. 1628 to the House floor today seems to close the door on the idea of Congress passing a major Affordable Care Act change law before health insurers file forms and rates for 2018 coverage.

House Speaker Paul Ryan said he thought he was making progress but could not win over enough to opponents to pass the American Health Care Act bill.

Related: Ryan pulls H.R. 1628, says ACA is here to stay

The story of the ACA has taken many amazing twists and turns, and the story of the AHCA bill could also move forward in strange and unexpected ways.

Maybe Ryan is just pretending to kill H.R. 1628, to make Republican opponents feel bad about themselves and agree to vote for it.

Maybe Ryan has some other alternative on his desk and his about to use despair over H.R. 1628 to rocket the new proposal through Congress.

Maybe Ryan expects the space aliens who have been responsible for all of the fake news, all over the world, to make their flying saucers visible and enroll us in FlyingSaucerCare. You never know.

Related: ACA: A history

But, assuming that Ryan’s efforts in the House to change the ACA in time to affect 2018 product filings really are in trouble, here are three ideas about what could happen next. 

Experienced agent citizen lobbyists might know where the flex is inside the Capitol. (Photo: J. Scott Applewhite/AP)

Experienced agent citizen lobbyists might know where the flex is inside the Capitol. (Photo: J. Scott Applewhite/AP)

1. Agents could become peacemakers.

The rules governing spending bills and budget measures are complicated, but maybe Senate Republicans could come up with an ACA-change alternative with strong appeal for House Republicans.

Or, maybe centrists in either the House or the Senate could create or find an ACA-change proposal that could get through Congress with genuine bipartisan.

Getting a bill through the Senate normally takes 60 votes. For complicated procedural reasons related to tax reform efforts, Congress can get one budget measure through the Senate with just 51 votes, if the measure gets through the Senate by late April, and it then can get a second measure through the Senate with just 51 votes.

The Trump administration has wanted to use one slot for ACA change, by late April, and the other for tax reform.

But, if an ordinary bipartisan ACA-change bill could get the support of at least eight Senate Democrats and independents, as well as the support of all Republicans in the Senate, and a majority of the members of the house, that bipartisan bill could come out later, without using up a budget measure slot.

Garrett Fenton, a benefits lawyer at Washington-based Miller & Chevalier, writes in a commentary that he believes the Senate could still proceed with its own ACA-change effort, “notwithstanding the House’s failure to reach a consensus.”

Sen. Susan Collins, R-Maine, put out a statement Friday asking for attention for a proposal she put together with Sen. Bill Cassidy, R-La., which would let states decide whether to stick with the ACA framework for commercial coverage or opt out.

If an effort to propose a new ACA-change effort emerges, and lawmakers and their aides realize that they’re in over their head, or have reaching across the aisle, maybe they’ll seek more input from people with good communications skills, who really understand how health insurance works, who’ve been spending years to build relationships all over Capitol Hill.

In other words: Maybe they could show a little more interest in the views of people like, maybe, you.

Related: NAHU educates Washington

Seema Verma ran a company that trained Indiana's HealthCare.gov navigators. (Photo: RebelMD/YouTube)

Seema Verma ran a company that trained Indiana’s HealthCare.gov navigators. (Photo: RebelMD/YouTube)

 

2. Seema Verma could become a lot more important.

Fenton writes in his commentary that, if legislative efforts to deal with ACA problems fail, then the U.S. Department of Health and Human Services might have to work harder to use regulations and guidance to stabilize the commercial health insurance market, and especially the individual major medical market.

The unit within HHS with the closest connection with commercial major medical market is the Centers for Medicare & Medicaid Services.

The new administrator of CMS is Seema Verma, who happens to be the former owner of a consulting firm that taught Indiana’s navigators how to help consumers sign up for coverage through HealthCare.gov.

She also has been involved with efforts to build health reimbursement arrangement features into the Medicaid programs in Indiana and other states.

The fact that Verma knows how part of the ACA exchange system really works could amplify her influence over however the system looks next year.

Related: Senate confirms Seema Verma as CMS administrator

The current mess might increase the attendance at any health policy seminars you happen to offer. (Photo: Allison Bell/LHP)

The current mess might increase the attendance at any health policy seminars you happen to offer. (Photo: Allison Bell/LHP)

3. Clients may value your problem-solving skills even more.

The ACA changed the health insurance market in ways that reduced insurers’ interest in attracting new individual major medical enrollees, and in paying agents to bring them those enrollees.

But the ACA also increased consumers’ and employers’ interest in hearing from agents and brokers who had taken the time to understand how the new health insurance world really worked.

Even benefit plan record keepers found that audiences were suddenly keenly interested in the nuances of employee counting.

The current confusion over the future of the ACA may intensity interest in what you know.

You may still have a hard time earning commissions, but maybe you could charge for health policy seminars. Or make a movie deal…

Related:

Agent develops H.R. 1628 alternative

He’s not afraid of the big, bad, ACA

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