Plumber? Attorney? Government Flack!

I have a quick question for the business owners in the audience – How’s it going? Been busy? Terrific. I hate to bother you, but the U.S. Government has another job for you. You are going to help steer Americans to the new Health Insurance Exchanges. And by the way, the gig starts today.

The legislators and staff who gave us The Patient Protection and Affordable Care Act (PPACA) may not have known anything about health insurance, but they were experts in the federal bureaucracy. The PPACA’s home address may be the Department of Health and Human Services (HHS), but the Internal Revenue Service, the Department of Labor and other federal agencies are involved with the implementation. The law has metastasized and can now be found throughout the government, which makes the raw meat mantra of defunding “Obamacare” that much more cynical.

So Mr. or Ms. Business Owner, how are YOU involved? This next section is from the Department of Labor’s website. It is safer to print this exactly as it appears rather than to paraphrase the governmentese and miss something.

Background On The Notice to Inform Employees of Coverage Options Under the FLSA

Section 18B of the FLSA, as added by section 1512 of the Affordable Care Act, generally provides that, in accordance with regulations promulgated by the Secretary of Labor, an applicable employer must provide each employee at the time of hiring (or with respect to current employees, not later than March 1, 2013), a written notice:

1. Informing the employee of the existence of the Marketplace (referred to in the statute as the Exchange) including a description of the services provided by the Marketplace, and the manner in which the employee may contact the Marketplace to request assistance;
2. If the employer plan's share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code (the Code) if the employee purchases a qualified health plan through the Marketplace; and
3. If the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

On January 24, 2013, the Department of Labor (the Department) issued guidance stating the Department’s conclusion that the notice requirement under FLSA section 18B will not take effect on March 1, 2013 for several reasons.⁽²⁾ The Department explained that this notice should be coordinated with HHS's educational efforts and Internal Revenue Service (IRS) guidance on minimum value. The guidance also stated the Department’s commitment to a smooth implementation process including providing employers with sufficient time to comply and select an applicability date that ensures that employees receive the information at a meaningful time. The guidance further stated that the Department expects the timing for distribution of notices will be the late summer or fall of 2013, which will coordinate with the open enrollment period for the Marketplace.

The Department is issuing this temporary guidance and model notice in advance of the expected timeframe announced in the guidance because, since the issuance of the guidance, the Department has received several requests from employers for a model notice on an earlier timeframe so that they may be able to inform their employees now about the upcoming coverage options through the Marketplace. Therefore, employers are permitted to use the model notice and/or rely on this temporary guidance prior to the applicability date stated below⁽³⁾ to inform their employees earlier.

OK. How about in English?

Employers must provide a notice to each employee about the new Exchanges. There is no clear exemption for small businesses. Some parts of the health care laws apply to businesses with over 50 employees. There are rules for businesses with 20 employees. This regulation applies to businesses with as few as ONE employee.

The Department of Labor has, thankfully, created a pair of model documents. This link takes you to the form to use if you provide health insurance for any of your employees. This link is to the form for those employers who don’t.

Both forms advise the employee that he/she may save money by purchasing health insurance on the Exchange. Both direct the employee to the government’s healthcare.gov website (the home of the internet’s largest collection of pictures of happy people). Both forms ask who at this business may be contacted to confirm information should the employee choose to apply for coverage on the Exchange. And if the employer provides coverage, there is a third page that asks the business to voluntarily provide additional information. Don’t volunteer.

What are the penalties for failing to comply? I have no idea. I gave up looking for that. I am preparing the forms for my clients. Some businesses are sending out blank forms. That would not appear to comply with the law.

How does a small business that doesn’t offer health insurance, and thus doesn’t have an agent, know to provide this form to its employees? You’re reading it. Click on the link and access the form. And how many of your people will sign up for coverage through the new Exchanges? We’ll set sales goals next week.

DAVE

Visit the website - www.bcandb.com

You Put Your Left Foot In

It was Chicken Cordon Bleu prepared by a lifelong vegetarian. It was a doctoral thesis that had been assigned to an illiterate. It was how I spent four hours and ten minutes Saturday evening. It was the federal government’s online classes for agents and brokers. People who have never purchased nor sold a health policy created these three courses:

• Affordable Care Act and Marketplace Basics
• Individual Marketplace Course
• SHOP Marketplace Course

I read. I passed the quizzes. I aced the tests. I am now qualified to sell policies that are still waiting for approval on a platform that has yet to be created. Welcome to health insurance August 2013.

The Patient Protection and Affordable Care Act (PPACA) mandates that individual health policies will be available through Exchanges. Because you can never find an insurance agent when you need one, Exchanges were to be created by every state as a way for Americans to efficiently shop for health insurance. If a state balked at the potential cost or hassle (or at, G-d forbid, appearing to in any way help implement “Obamacare”) the federal government was empowered to create its own Exchange or a state / federal hybrid. Ohio has opted for the hybrid.

The PPACA mandates Exchanges, but in a widely misunderstood and disliked law, the concept of Exchanges ranks near the bottom of consumer and employer acceptance. So the marketers at the U.S. Department of Health and Human Services (HHS) have given us a new term – Marketplace.

What is a Marketplace? Think Exchange.

Today I learned how we in Ohio, which once had hundreds of choices for small group health insurance, will now have more choices even if the actual number of options is way less. Go ahead and re-read that sentence as many times as necessary until it makes sense. I also learned that there are only nine easy steps for a small employer (2-50 employees) to purchase health insurance coverage for his/her employees through the SHOP Exchange.

The individual Exchange is one way someone can purchase personal health insurance coverage. Why bother with the Exchange? $$$$ Individuals and families earning between 100% to 400% of the federal poverty level will qualify for subsidies. You have to go through the Exchange to qualify for the subsidy. Well over 50% of all applicants will get some premium assistance.

You can almost hear the border collies herding everyone to the pens.

We have been promised a single, streamlined form that could be completed by an individual, done over the phone with a government employee, or prepared online. The online version sounds like it will be the easiest option. The insurance shopper will be able to do this alone, with a qualified agent, with the yet to be fully defined Navigator, or with a volunteer.

The form will ask:

• Your name
• Your date of birth
• Your address
• Your citizenship / residency status
• Your marital status
• Do you smoke
• Are you incarcerated
• Your Social Security Number
• Your income
• Do you have access to a qualified, affordable health plan at work

Are you eligible for government provided health care
And of course, if they are covering any of your family they will need all of the above for them. The form has yet to be released. There may be more questions on the actual form.

The government will verify your answers through the appropriate agencies and determine your eligibility. Once you are advised of the amount of your subsidy, you may begin to shop for insurance.

A large portion of today’s classes dealt with how to safeguard the PII, Personally Identifiable Information. We have been protecting our clients personal information for years. My office is safe. My records are private. The government should do so well. What has yet to be determined is how the Navigators and volunteer organizations will protect the taxpayer information that will be routinely collected.

Four hours of this silly dance. I suspect that I’ve got another hour with the feds next week. The State of Ohio will have its own class sometime in September. If this is a war of attrition, they’ve picked a fight with the wrong guys. Thirty-five years in the business, I’m ready for the marathon. But I am frustrated with the Hokey-Pokey.

DAVE

www.bcandb.com

How Do You Spell "Knife"?

There was a time when children would ask a parent or a teacher how to spell a particular word. The adult would inevitably send us to the dictionary. This would often prove to be a lesson in self-reliance, problem solving, and phonetics. But English being English, a dictionary search could also be a frustrating waste of time.

Senator Sherrod Brown invited me to a seminar. The invitation stated that he was bringing the U.S. Department of Health and Human Services to Cleveland on August 8, 2013 to answer questions about the Marketplaces or Exchanges. I emailed my RSVP within minutes of receiving the invitation.

We have all seen a young cheerleader whoop it up after her side’s quarterback has thrown an interception, totally unaware of the gravity of the situation. Well, in the last few weeks I have been on two phone conference / webinars with the Centers for Medicare and Medicaid Services (CMS). As previously noted, the government employees hosting the meetings were woefully unprepared. Cheerleading permeated each seminar. After a basic slide show presentation high on platitudes but almost bereft of facts, questions were thrown to the hosts, who, like the Browns’ receivers, quickly dropped them. These meetings were frustrating wastes of time.

I was counting on Senator Brown to host an informative meeting. Based on the email address, I could tell that this invitation was sent to his supporters, people who had worked on the campaigns and maybe even donated to his campaigns in the past. This was going to be a friendly crowd.

The seminar was scheduled for 5:30 – 7:00 PM at The City Club. That lack of awareness should have been a tip-off. His staff didn’t know that the Browns were playing their first preseason game that night or that the Indians were hosting a Dollar Dog Night game against the Detroit Tigers. Both a few blocks away.


By the way, it shouldn’t be necessary to note this, but the Patient Protection and Affordable Care Act (PPACA) lives at the U.S. Department of Health and Human Services (HHS). Senator Brown bringing in HHS should be the equivalent of having a Supreme Court Justice explain the Constitution.

Wrong Again

Arriving at 5 PM, I knew I had wasted my time the moment I walked into the empty room. Instead of the Senator and an advance team, I saw a couple of staffers and Sherrod on a screen in the front of the room. All they had to do is hit play and we would be treated to a quick canned intro from the Senator. If this presentation wasn’t going to be good enough for him to show, I already knew that I had blown $20 on parking.

The room was eventually filled with leaders of various not-for-profits, Democratic activists, and the terminally confused. There were only three insurance agents in the room. The vibe was positive right up until the presentation started.

Our young presenter was from Chicago. We knew this because she mentioned it, and her need to catch a plane, frequently. Being from out of state was a double liability for her. She was not prepared to discuss the new regulations and she was often wrong about the Ohio health insurance marketplace. Worse, the audience quickly sensed her numerous shortcomings.

Ms. Chicago may have left her pom poms at home, but she was a determined, if not talented, cheerleader. She begged the audience to remember www.healthcare.gov. Begged is not an exaggeration. She told us that the government’s website is the answer to every question you could possibly have about health care and the solution to ANY problem you may ever encounter.

I was sitting next to the executive director of one of the dread disease foundations. My tablemate, a young woman in her early thirties, quickly grew frustrated with our presenter’s mistakes, inability to answer the most basic of questions, and repetition of the website address.

If someone representing the U.S. Department of Health and Human Services can’t answer a basic question, who can? I asked a question about the Personal Responsibility Fee, which is the new Orwellian way to say the Individual Mandate. I won’t bore you with the question. She couldn’t answer it. Worse, she said that the answer would have to come from the Internal Revenue Service. THAT IS WRONG. The IRS may have a hand in administering the PPACA, but HHS is writing the rules.

But we still have the website. Good luck finding the answer to your questions there. And we still have dictionaries. The huge Webster’s Encyclopedic Unabridged Dictionary of the English Language sitting on my bookshelf may have almost every word in the English language, but it is still a challenge to find the correct spelling of some words. Sometimes it’s darn near impossible. Don’t believe me? Have your child look up "knife".

DAVE

www.bcandb.com

Everybody's Happy!

A billion here, a billion there, and pretty soon you're talking real money.
Senator Everett McKinley Dirksen (1896-1969)

The new rates are out!  The new rates are out!  The Cleveland Plain Dealer reported today (won’t be able to say that much longer) that we finally have the new individual rates under the Patient Protection and Affordable Care Act (PPACA).  These are the prices that Ohioans will pay if they purchase coverage through the new exchanges.  And everyone is thrilled.  Positively giddy.

Mary Taylor, Lt. Governor and Insurance Commissioner, announced that our rates will be going up an average of 41%.  The Ohio Department of Insurance is projected our average adult premium will be $332.58 per month.  The Democrats were happy since they were worried that the number was going to be higher.  The Republicans were celebrating another opportunity to complain about escalating costs.  And average Ohioans, numb from way too many political ads last November and the recent budget shenanigans, chose to focus on the streaking Cleveland Indians.

Of course, loving the numbers wasn’t really good enough for either side.  Thankfully there are plenty of chances to evangelize their message and fight with the other side.  And everyone has a dog in this fight.

Approximately 80 – 90 percent of the people purchasing policies on the public exchange will qualify for a subsidy from the federal government.  As we have discussed previously, the federal government will help you pay your health insurance premium if you earn between 100% - 400% of the federal poverty rate.  That means if you earn less than $45,960 as a single or $94,200 as a family of four, you may qualify for assistance if your employer doesn’t provide adequate group health insurance.

The left is happily furious that Ms. Taylor reported the real number, $332.58, and not what someone might pay if he/she qualifies for a subsidy.  The Plain Dealer article notes that a 30 year old making $30,000 per year would have a premium of $285 per month, but that the federal government would cover $76 of that monthly fee.  Our hypothetical 30 year old would really have a premium of $209 per month.

At the risk of appearing to take sides – BALONEY!

1. The premium really is $285.  Some of it will be paid by the insured and the rest will be paid, in real dollars, to the insurance company.

2. That $76 is actually $912 in year one.

3. President Obama postponed the employer mandate, the tax that was scheduled to cover the cost of subsidizing the individual policies.

4. The uninsured 30 year old that was in my office yesterday was thrilled to acquire a health policy for $92.39 per month.  She would not have purchased a $209 policy.  And yes, coincidentally, she is a hairdresser making $30,000 a year.

The good news is that if my 30 year old hairdresser is forced to purchase a policy through the exchange next year, she will be acquiring maternity coverage at no additional cost.  She doesn’t think that she needs it, but it couldn’t hurt.  My healthy thirty year old male clients are looking at larger price bumps without a meaningful increase in benefits.

The Patient Protection and Affordable Care Act was supposed to be revenue neutral.  Sure there were costs associated with implementing the bill, but there were sources of revenue, too.  The first to disappear was the CLASS ACT, a program that was to pay for long term care eventually but front-load some early money for the PPACA.  That program ended almost two years ago.  The real money stream was to come from the employer mandate.

The nonpartisan Congressional Budget Office has estimated that delaying the employer mandate will cost us $12,000,000,000.  The Washington Post also reports that the CBO estimates that as many as 1 million fewer people will be insured due to the delay.

While the left denied the existence of mathematics, the right pretended that everyone in our country has access to comprehensive health care.  Blinders on and fully aware that their actions are equivalent to doing nothing, the Republicans of the U.S. House of Representatives voted today for the 40^th time to repeal all or most of Obamacare (PPACA).  Then they went home for the summer recess.  This vote was so irrelevant that the major new outlets ignored it.

But back to Ohio.  Our rates are going up, but it could have been worse.  If you are unhealthy, pregnant, or earning less than 400% of the federal poverty level, the policies may prove to be a good deal.  And if you’re not, well the Indians are 60 – 48.

DAVE

www.bcandb.com

The Death Spiral

I used to be a hero. At one point we had quite a few nanny placement services in Greater Cleveland and many of the young women were hired to work in New York. Most of these agencies referred their clients, the potential employers, to me for the health insurance needs of the caregivers. The ones who called were very happy. One of my health insurance companies would allow an Ohio policyholder to retain her coverage even if she moved to New York City. Otherwise, she or her employer would have had to purchase a policy there.

The Ohio policy was hundreds of dollars less per month.

Hundreds. Fifteen years ago. The spread is much higher now.

Two important questions:

1. Why are Ohio policies so much less?
2. Why are there 2.6 million uninsured in New York?

It has been said that the road to Hell is paved with good intentions. It is hot, really hot, in New York. Years ago it was decided that all adults under age 65 should pay the same premium. Twenty-two or sixty-two, the price is the same. That sounds great if you are in your sixties, but it only works if you can drag the twenty-somethings to the table. In the beginning your average participant age is in the mid-forties. As the young drop out, the average age, and the price, increases.

But age wasn’t the only pricing determinant abandoned in the interest of fairness. New York insurers were forbidden to underwrite the risks. The sicker you are the better that deal. An insulin dependent diabetic with AIDS pays the same premium as someone who is perfectly healthy. The system, in essence, welcomed pre-existing conditions and penalized the young and healthy.

And of course, the cost of living is higher in New York, especially in NYC.

As we have noted previously, Ohioans, on average, pay a lot less for health insurance for all of the reasons that New Yorkers pay more. I have lots of clients, male and female, under the age of 30. Some of these young adults shopped for this coverage and pay for it themselves. The rest of these cases have some degree of parental involvement. It is much easier for a parent to come up with $70 to $120 a month in Ohio than hundreds more in New York.

Why are there millions of uninsured New Yorkers? The 2.6 million number is actually from six years ago. That number hasn’t gone down. New Yorkers weren’t required to purchase insurance. There was no Individual Mandate. Penalized for their health and youth, many New Yorkers simply chose to not participate. Making insurance affordable might get them back into the market. Making insurance mandatory will have more impact.

It has been announced that the New York rates will be plummeting under the Patient Protection and Affordable Care Act (PPACA). Governor Cuomo is ecstatic. The President is pointing to New York as a model for the future. And it is true, at least for the moment, that New York rates are coming down. A lot. But if you consider $1,000 per month normal, your great bargain may still sound awful to consumers in Ohio. This link is to an article that dreams of young people paying only $190 for a basic policy, one that a guy living in Cleveland might buy today for $70!

Will the New York rates stay cheap? There are two major speed bumps ahead. The first is the PPACA. The 2014 New York rates are certainly much less than the current pricing, but are they cheap enough? Will the subsidies be enough to spur sales when the penalty (tax or fee depending on your political persuasion) is only $95 or about 1% of income? With the penalty so low, enforcement challenging, and the entire process confusing, the prediction is that many of the currently healthy uninsured will sit out a year or two. Lose the young and healthy and New York is right back where it was.

The second speed bump facing New York is the U S House of Representatives. The Republicans sensed weakness in the Obama administration’s decision to shelve the employer mandate for a year. (See previous blog) Last week the Republicans attempted to put the individual mandate on hold, too. Of course the bill passed the House. And you might think that the bill will never see the light of day in the Senate, but don’t be so sure. Punting the individual mandate might seem like a good idea to a group of people who are used to putting off important decisions and deflecting responsibility.

Both the Democrats and the Republicans have a reason to kill the individual mandate. As New York already proved, if we create super health policies that do everything but drive you to the doctor, don’t factor in the health conditions of the insureds, and don’t weigh the premiums properly for the ages of the participants, the rates will go through the roof if you can’t corral the young and healthy into the insurance pool. Without an individual mandate forcing participation, you create a death spiral. As the rates increase to reflect the claims, the young and healthy leave. First the twenty somethings jump out. Eventually the average age of the participants will be over 50. Prices will be out of control and there will be only one answer – Single Payer.

Your friends in New York and California are celebrating the health insurance rates they expect to see in 2014. It would be tacky to point out that their new rates will still be significantly more than the rates we pay today. And it is just sad to think that our new rates and their new rates are going to be about the same.

DAVE

www.bcandb.com

Get Ready. Get Set. STOP!

T.S. Eliot famously wrote that the world would end “not with a bang but a whimper”. The Obama administration must be Mr. Eliot’s biggest fans.

The Patient Protection and Affordable Care Act (PPACA) was signed into law, amid great fanfare, on March 23, 2010. Major rules and edicts are released by Kathleen Sebelius, Secretary of Health and Human Services, almost every Friday. The entire process, if neither practical nor well thought out, has at least been well choreographed. So imagine the universal surprise everyone experienced with last Tuesday’s whispered announcement.

Mark Mazur, Assistant Secretary for Tax Policy at the Treasury Department, posted in an official blog that the enforcement of the employer mandate would be postponed for one year. The provision that medium and large employers (50+ employees) would be required to provide adequate and affordable health insurance to their workers has been put on hold.

In a blog!

Rules and regulations will be released next week. One of the most complicated portions of the PPACA, a series of requirements that have caused businesses and insurers uncounted headaches since the day the law was passed, is kicked back a year and the information is released through a blog, during a holiday week, while the President is on a plane thousands of miles from the U.S.

Now don’t get me wrong, this blog has asserted as recently as last week that the PPACA needed significant revisions and that it was a shame that the Democrats in Congress seemed incapable of fixing even the largest of problems. They still aren’t. The Administration should be commended for doing something, anything, to avert what has been called a “train wreck”.

Style Points – 0

We are waiting for the details to award points on substance.

Before we get to what this means, let’s first hear from the usual suspects. Fans of the PPACA were swift to point out that they never really liked the employer mandate.

Ezra Klein noted in Wonkblog, his excellent online work for the Washington Post, that the employer mandate is a “bad bit of policy” and that it was initially pushed by business groups.

Steve Benen wrote in MaddowBlog, the official blog of MSNBC’s Rachel Maddow, that this wasn’t really that big a deal since “the delay won’t affect the creation of the exchanges, which should help bridge the gap—folks working for businesses that don’t offer coverage will still be eligible for subsidies they can use to buy insurance in their state marketplace.” (Different site, same picture)Striking a conciliatory tone, E. Neil Trautwein, a vice-president of the National Retail Federation, said that is was a ‘wise move” and that it “will provide employers and businesses more time to update their health care coverage without the threat of arbitrary punishment.”

The Republican Leader of the Senate, Mitch McConnell (R-Ky) released a statement that “the fact remains that Obamacare needs to be repealed and replaced with common-sense reforms that actually lower costs for Americans.” Translation – I got nothin’

What does it mean?

According to our friends at Anthem Blue Cross, the immediate results of this decision by the Obama Administration are that certain parts of the PPACA will go into effect on 2015 instead of 2014:

Employers will not have to report certain information to the IRS. This has been referred to as “employer reporting requirements”.

The rule that says large employers have to offer coverage to full-time workers or pay a penalty. “Large employer” in this case is a business that has 50 or more full-time or full-time equivalent employees (that work an average of 30 hours a week).

The rule that says coverage offered by large employers cannot be more than 9.5% of a worker’s pay for self-only coverage.

I would add a fourth. If employers aren’t required to offer coverage, then group health policies (employer sponsored) are not required to comply with the PPACA’s laundry list of Essential Health Benefits. Large employers will still be able to determine whether they choose to offer Birth Control, IUD’s, and the Morning After Pill as well as other controversial elements of the President’s plan.

This last issue has been a huge point of contention. The federal government now has an additional twelve months to resolve these issues. Unfortunately, only Congress can repair the major flaws of the PPACA, and that is unlikely to happen. Even if the Democrats were capable of drafting the legislation necessary to make the PPACA effective, the Republicans are too dug in, too invested in the law’s failure at any cost, to throw it a lifesaver.

So we have been set adrift. Our only hope will be more regulatory fixes, engineered by the Administration, released by underlings in blogs or buried deep within reports. All the while employers work and rework their business plans to comply with rules that may change at any time.   Dave   www.bcandb.com

The Tar Pits Are Calling

Giant Eagle. Ask a small child where hot dogs come from and he will answer the name of the last place he rode around in a shopping cart. This is the beginning of a conversation about farms, animals, and possibly soy beans.

The H.R. Department. Ask a government bureaucrat or one of our elected officials where a health insurance policy comes from and they might tell you that all of that paperwork originated with Marge in H.R. And this is the beginning of a conversation about how many of us get our health insurance, from agents servicing individuals, small businesses, and the self-employed.

This blog, Health Insurance Issues With Dave, has been published for over 4 years. The original posts were more personal and had less graphs and links. But this now appears in three formats and has readers around the country, so there is usually less of me and more of a straightforward presentation. At the risk of shocking or irritating a few of my readers, today’s post will be more personal, more like the originals.

Let me be clear – I am very concerned. I’m concerned about the country and how we manage the self-inflicted mess we are about to encounter and I am concerned about me.

Now before our friends on the right get excited and our friends on the left, agitated, we need to state that there is plenty of blame to go around. Neither side has listened to the other. For good or ill, the Patient Protection and Affordable Care Act (PPACA) is the law of the land. One side has done everything it can to undermine the legislation without any concern for the impact their actions might have on their constituents. The other side lacks the fire power to execute this massive transition and is too stubborn to pull back to get this right.

Stubborn – Incompetent – Unconcerned About the Collateral Damage

Too be honest, it is easier to pick on the Democrats, the Department of Health and Human Services, and the President because they are doing something. It may be Grade C work, but if you are comparing them to Mitch McConnell and John Boehner, then C beats incomplete any day of the week. In fact, when it comes to the health care debate, the Republican leadership is simply AWOL.

Last week’s post dealt with the federal government’s invitation only webinar. The facilitator was asked for some specifics about the “Metal Plans”. She quickly pooh poohed the question. From the start, the PPACA has presumed that there would only be a couple of plan options. Since it is pretty obvious that none of the people who wrote the law have ever actually shopped for insurance, they had no idea what they were creating. They envisioned a system so simple that even an untrained navigator could help the computer illiterate enroll in coverage.

I have been given an advance peek at one company’s plans for the new exchange. To comply with the law, these policies are far more complicated and limiting than the current plans. Provider networks are shrinking. Simple deductible / 100% plans are disappearing. Determining the right policy for an individual or family may take more time, not less, in the future.

To counter this reality, Secretary of Health and Human Services Kathleen Sebelius excitedly announced this week the creation of a new website and telephone call center. The number is 1.800.318.2596. The website is www.healthcare.gov. Sure the Government Accountability Office (GAO) has found that the federal government and many of the states are “behind schedule”. Sure we have less than 100 days till the exchanges are supposed to be up and running. But we have a website and a call center all prepared to tell us how wonderful everything is going to be.

I went to the website. It is information light and propaganda heavy. At one point I found this nugget on the small business page: Insurers can no longer charge more for women. Of course we know that in the small business market, women are charged more than men at some ages and less than men at other ages. In other words, the rates reflect the risk. If the government was interested in presenting facts instead of simply selling, the page would note that rates will now be gender neutral. I would tell you more about the site, but they still have work to do on it. My computer froze while on the site and I had to reboot to get back to work.

I’m worried about us because these people are in over their heads. They’ve got the pitch memorized but they don’t understand the product. And they don’t know enough to care.

And I’m worried about me. I have been doing this since 1979. The things I know and the work I am capable of doing, is no longer valued and may not be compensated. I have about 500 clients. Most of them have employees. They are all impacted by these changes. Some will save money. Some of my clients are about to take a hit. Each needs a personal strategy. Each needs time, my time. And the truth is that none of my peers knows, today, how much time we will be able to spend with our clients.

Tuesday I talked with an agent who is abandoning the individual market. Too much time. Too much effort. Too little money after the last round of commission cuts. He wants to spend all of his time working with businesses with 50 or more employees. He is a fifteen year veteran of this business. His clients will notice his absence. He can’t be replaced by a volunteer from the local union hall. And neither can I.

On October 1, 2013 we will not enter the gates of insurance heaven nor fall into a dark abyss. No, it will be something in between, mediocre, messy, but just close enough to warrant, at least initially, a C.

And I will fight on for me and for my clients. But I would have to be deaf or in denial if I said that I didn’t hear the tar pits calling.   www.bcandb.com   DAVE