NAHU represents licensed health insurance agents, brokers, consultants and benefit professionals who serve the health insurance needs of employers and individuals seeking health insurance coverage.
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Americans desire a healthcare system that delivers world-class care and financial security. This system should be accessible and affordable, and it should have a positive impact on the nation's economy. Successful healthcare reform will maximize consumer choice, restrain skyrocketing medical care costs and increase access to healthcare for more Americans. NAHU has consistently supported positive reform that achieves the objectives of affordability and accessibility. We have also consistently urged Congress and the President to build upon our existing system's strengths to achieve workable health reform solutions in a bipartisan manner.

An American Solution—NAHU's Vision for Affordable and Responsible Healthcare Reform is NAHU's comprehensive approach to meeting this challenge. Our detailed federal government relations priorities and talking points for 2014 provide more information.

In particular, NAHU believes the following issues to be critical to maintaining a responsible, accessible, and affordable healthcare system for all Americans.

Value of Agents, Brokers and Consultants

As implementation of the Patient Protection and Affordable Care Act (PPACA) progresses, NAHU is dedicated to ensuring continued access to the crucial services of state-licensed health insurance agents, brokers and consultants who work on a daily basis to help individuals and employers of all sizes purchase health insurance, use their coverage effectively and make sure they get the most out of the benefits they have purchased. Consumers' need for help from a licensed professional will only increase as the new health reform law is fully implemented and the compliance demands on employers and individuals increase.

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Containing Healthcare Costs

By far, the greatest access barrier to health insurance coverage in America today is cost. Constraining skyrocketing medical costs is the most critical—and vexing—aspect of healthcare reform. The cost of healthcare delivery is the key driver in rising health insurance premiums and it is putting the cost of health insurance coverage beyond the reach of many Americans.

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Medical Loss Ratio

NAHU strongly supports the goals of reducing healthcare costs, improving health outcomes for patients and providing better value for healthcare consumers. However, the financial livelihood of independent health insurance agents and brokers nationwide is directly threatened by PPACA's medical loss ratio (MLR) requirements, which require health plans to treat independent agent and broker compensation as part of their administrative costs, even though agents run their own businesses, hire their own employees and pay all of their own expenses, such as professional liability insurance.

It's critical that the health reform law's MLR requirements be changed so that consumers can continue to have access to professional independent health insurance agents and brokers. This provision has already resulted in service reductions and lost jobs and, if it is not changed, the economic disruption the MLR requirements have already caused is expected to accelerate.

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Health Insurance Exchanges

The establishment of health insurance exchanges is one of the most significant reforms contained in PPACA. Exchanges will transform our nation's private healthcare marketplace for individuals and small businesses buying coverage. Since it is the professional role of health insurance agents and brokers to provide consumers with accurate information about their health coverage options, we believe that exchange participation is a natural fit. However, as health insurance exchanges are created by both the states and federal government, we must ensure that they allow individuals and business owners to utilize traditional agent and broker services. Exchange consumers will need agent and broker access not only during the annual enrollment process, but also to handle their policy service needs on an ongoing basis.

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The Impact of Health Reform on Our Nation's Employers

NAHU members are mostly small business owners, and they know all too well how the high costs of medical care and new health coverage requirements are hindering our nation's economic growth. When these cost drivers are combined with the myriad of new notice requirements and other compliance procedures that employers must now perform for and on behalf of their employees, it is no surprise that many companies are re-evaluating their decision to provide health coverage to employees in the future.

To ensure that employers continue to invest in their employees' healthcare needs in the years ahead, NAHU believes that many of the new health reform requirements that are discouraging employer-sponsored coverage should be addressed quickly.

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Market Reforms

Great care needs to be taken when implementing health insurance market reforms to prevent cost increases in the existing private market system. No matter how fair a market reform idea might seem on its surface, it's not at all fair if it also prices people out of coverage options. NAHU suggests creating strong financial and insurance-related incentives for consumers to maintain continuous coverage—even when they are healthy. As experiences in some states have made clear, if you don't give consumers reasons to maintain coverage and you don't allow health plans to evaluate for risk, the cost of coverage ultimately increases. Further, PPACA stipulates that as of January 1, 2014 all states must conform to a strict age – band of 3:1. Forty-two states nationwide have in place a 5:1 age-band. This mandated “over-night” change to a 3:1 ratio will a “rate shock” that will result in significant market disruption and cause insurance prices for younger American’s to skyrocket. NAHU is concerned that unless changes are made to PPACA's market reform requirements, they could deny many Americans access to affordable insurance, even if such insurance is federally subsidized.

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Long-Term Care

As the baby boom generation ages, there will be an increased demand on long-term care services, which will place a significant and unsustainable strain on state Medicaid budgets. However, if more individuals were able to privately finance their LTC needs, the cost savings to both the federal government and the states in reduced Medicaid expenditures would be enormous, as Medicaid is currently the primary payer of American LTC costs. One simple change to federal law that would have far-reaching benefits would be to include LTC insurance premiums in Section 125 plans to encourage employers to offer such coverage to their workers as either a voluntary or subsidized benefit.

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Preserving Private Medicare Choices

All Americans, including Medicare beneficiaries, need to have a wide range of health plan choices available to them and the ability to pick the policies that best suit their individual needs. Congress should not limit the ability of seniors to access any Medicare coverage option, nor should they restrict senior access to the services of licensed professional health insurance producers. Policymakers should also refrain from financing deficit reduction measures or other healthcare reform programs on the backs of our nation's senior citizens by changing the funding of their private Medicare coverage options. Preserving the financial stability of the Medicare program, and its private option counterparts, is critical as well.

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