Congress should try to make health insurance market rules friendlier to insurance agents and brokers, because agents and brokers are more effective at getting people covered than navigators are, according to J.P. Wieske.
Wieske, the vice president of state affairs at the Council for Affordable Health Coverage (CAHC), made that case last week at a hearing on health care costs organized by the House Energy and Commerce health subcommittee.
Wieske has been affiliated with groups that promote a market-based approach to health finance system change for years. He was deputy commissioner of insurance in Wisconsin under Wisconsin’s former Gov. Scott Walker, who is a Republican.
Democrats now control the U.S. House. In addition to promoting other CAHC priorities, such as offering states flexible reinsurance programs, Wieske told House Democrats, and their Republican colleagues, about the value agents and brokers offer consumers in the individual major medical market.
The ACA requires ACA exchange program managers to set up navigator programs, or programs that offer consumers help with understanding how to use the ACA exchange system.
In Wisconsin, navigators had a “limited value” in getting people covered, Wieske said at the hearing, which was streamed live on the web.
“I think it’s been much more effective to use agents,” Wieske said.
In Wisconsin, navigators tend to be clustered in urban areas, and they tend to work with consumers mostly when the consumers are signing up for ACA exchange plan coverage, Wieske said.
Rural communities are much more likely to have insurance agents than to have ACA navigators, and agents are more likely to have an ongoing relationship with their clients, Wieske said.
Not All the Navigators’ Fault
The U.S. Department of Health and Human Services (HHS) provides ACA exchange services in Wisconsin through HealthCare.gov. HHS has been funding HealthCare.gov’s Wisconsin navigators through grants.