NAHU Examines Health Market Stabilization

By Susan Rupe InsuranceNewsNet

Increasing market stability after the Affordable Care Act is repealed and replaced is a theme of one health insurance agents association’s visit to Washington this week.

Members of the National Association of Health Underwriters (NAHU) are gathering in the nation’s capital for their 27^th annual Capitol Conference. The purpose of the conference is to examine what Congress will do to health care reform as repeal-and-replace moves forward.

The conference comes on the heels of NAHU CEO Janet Trautwein’s testimony before the Senate earlier this month. Trautwein spoke on increasing market stability and options for ACA repeal and replacement before the Senate Committee on Health, Education, Labor and Pensions.

In her remarks, Trautwein acknowledged that many Americans gained coverage as a result of the ACA, but NAHU members “are finding it increasingly difficult to help their clients find affordable high-quality health insurance coverage, particularly in the individual health insurance market.”

The problems in the individual market, Trautwein said, are largely due to adverse selection. This occurs as consumers wait until they are sick to obtain coverage or drop coverage as soon as they have been treated for their illness. The result is an imbalance in the risk pool, with not enough healthy people enrolled to offset those enrollees who are sicker.

Trautwein cautioned lawmakers that they must take immediate steps to stabilize the health insurance marketplace since some decisions made during the repeal and replace process “could create problems in an already troubled market.”

It is possible to retain many of the current provisions in the ACA – such as guaranteed issue coverage, coverage of pre-existing conditions and keeping children on the parents’ policies until age 26 – while making other changes that will help bring down coverage costs and increase options for consumers, Trautwein said. She called for Congress to look at the ways people are enrolled in coverage and how to encourage those enrollees to remain covered.

NAHU made the following recommendations for changing the ACA:

Special enrollment periods should be limited only to those clearly defined in the ACA. In addition, enrollees should be required to submit documented proof by the 15^th of the month before coverage would take effect.

The extended 90-day grace period for those who receive premium tax credits should be reduced to 30 days.

“Grandmothered” policies should be continued beyond their scheduled expiration in 2017.

Redefine the Medical Loss Ratio formula to exclude broker commissions in the same way taxes are excluded from the formula.

Remove the requirement for standardized benefit plans to be offered in the health insurance marketplaces.

Simplify employer reporting requirements.

Remove limitations on keeping grandfathered plans.

Former CMS Chief on Speaker List

Marilyn Tavenner, CEO of America’s Health Insurance Plans and former Centers for Medicare & Medicaid Services administrator, will be among those speaking during the conference. Tavenner will present “A Discussion on the Perspective of Insurance Carriers Navigating an Ever-Changing Marketplace.”

Also among those scheduled to speak are Sen. Bill Cassidy, R.La., sponsor of The Patient Freedom Act; Sen. Tom Daschle, D-S.D., discussing the past and future of bipartisan health care policy, and Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor and Pensions Committee.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].