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Capitol Enlightenment

3/27/2018

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Recently, my partner Mike and I returned from Washington, D.C., after our annual trek to the National Association of Health Underwriters (NAHU) Capitol Conference. Mike and I are the legislative co-chairs for the local chapter of NAHU. Our trip involves communicating our clients’ issues regarding the health care market and identifying positive ways of improving the current state of affairs. As you might imagine, similar to the past six years, there were plenty of issues to discuss.
The three major areas of discussion included:
  • Market stabilizers to reduce cost and improve employer and individual risk pools
    • Individual market
      • Talking points surrounding greater consumer flexibility and allowing states to be eligible to fund new hybrid high-risk pools to mitigate the effect of high claims on premiums.
    • Employer market
      • Topics including preservation of the Employer Tax Exclusion, allowing employers and employees to enjoy the tax benefits and affordability of employer sponsored insurance. Also, increasing consumer flexibility for Health Savings Accounts (HSAs) and easing the arduous reporting requirements that large employers are currently subjected to.
  • Taxes and other market stabilizers
    • Specific talking points, including a permanent repeal of the Health Insurance Tax and the Cadillac Excise tax, both of which have an inflationary effect on premiums, especially for the middle class. Also, allowing more flexibility for states in the 1332 waiver process to accommodate local markets and enhance consumer choice.
  • Medicare
    • Three talking points surrounding greater consumer flexibility and reduced “Red tape” for agents and brokers to assist qualified beneficiaries.  Also, allowing COBRA coverage to be considered “Credible Coverage” for Medicare Part B eligibility.
It’s always eye-opening to see how many of our elected officials don’t entirely understand how the real world works, in respect to healthcare and the associated insurance solutions. While the summary above is brief, we feel that our conversations were productive. Our visits help enlighten these officials on the real world problems and assist in forming solutions.
And while we feel there is a window of hope for improvement, there are still problems that need to be resolved. For example, as a “Treasury Watchdog” reported in the Washington Times, the IRS overpaid nearly $3.5 billion in ACA tax credits in 2017, of which it can no longer recoup due to constraints built into the act. Makes you wonder who’s really watching the henhouse (or, who’s drafting the legislation)!
Despite the ongoing turmoil surrounding the ACA and healthcare in general, we will continue to listen to our clients, proactively discuss solutions and hope for wholesome free market solutions as time moves on. In the interim, we’ll be here to provide continued guidance in this ever confusing and complicated world of options.

1 Overpayment resulted from outflows of $24 Billion in subsidies with $5.8 Billion in overages of which only $2.3 Billion was clawed back because of limits on the $ amounts that can be recovered.
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