What the Health? The Republican Healthcare Bill

Our country’s fight over healthcare has reached a climax like one of those old movies where a mob of screaming townspeople back someone off a cliff. In this version the townspeople are Republican politicians, ceaselessly dogging the ACA on every news channel and podium available, what’s about to be backed off a cliff is the ACA itself—and once it hits the rocks below, it’s looking more and more like we won’t ever have anything like it again.

The Republican healthcare bill has finally been released to the public, and with it being universally panned by national health organizations including the AARP and the American Medical Association, Sean Spicer using stacks of paper to try and read meaning into it, and it containing nothing that Trump promised his supporters—like competition across state lines—it’s not so much a replacement proposition as it was a chance to buy time. It was a cheap tactic by Paul Ryan and his cronies to essentially crowd test new healthcare policy, and make it appear as though Republicans don’t have their proverbial dick in their hands when it comes to replacing Obamacare.

But amidst the fierce battle within Congress on replacement strategies, and town halls filling beyond capacity with enraged constituents terrified of what losing their ACA-subsidized healthcare will mean, there’s one area of the health insurance industry that has been largely ignored both by government, within the public conversation, and certainly with this new bill: health insurance agents.

It’s become crystal clear that health insurance is complex (which John Oliver underlined last week, mocking Donald Trump’s asinine recent proclamation “Nobody knew healthcare was complicated”). And it’s not just from a policy standpoint, it is also from the industry side. Things like deciphering plan structures, and how their webs of co-pays, deductibles and maximum out of pockets weave together to protect you—or leave you exposed—in the event of an emergency, or just the flu, can be overwhelming if not impossible to understand for your average insurance buyer. There are also other hidden stipulations to be understood such as which hospitals and providers are in a plan’s network, and since the ACA, how your plan will be paid for, and the intricacies of healthcare.gov. This is why insurance brokers exist. They are trained, licensed industry professionals who communicate with insurance companies, providers and within the large broker community to sort out trends, facts and most importantly lead you in the right direction.

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Insurance agents can sometimes be preceded by damaging stereotypes. The archetype of the disheveled insurance salesman who pushes shady products for profit can be seen in plenty of old movies. That misconception certainly has affected the industry, but in today’s age of corporate insurance giants, it is by and large false, as long as you’re seeking out agencies with the right credentials—meaning that they are licensed by state, but also appointed with top carriers at high levels (something that is not easily accomplished)—and decorated within the industry. All insurance companies give out annual awards to top producers and industry leaders. If you’re working with an agent without any kind of acknowledgements from insurance companies, they probably are not your most prudent choice.

Unfortunately despite the incredible hoops that the industry requires of agents in order to become decorated and successful in their fields—annual, time intensive education requirements, costly state license appointments, countless hours of market research, product seminars, and for the past four years laborious annual Marketplace certification—insurance agents were the first collateral damage of the Affordable Care Act.

The ACA made health care even harder to understand. By adding an online component, that was convoluted, unintuitive and often simply not working, health insurance became a computer game of sorts. It has historically been unclear in healthcare.gov how one was expected to report income, in order to get the appropriate amount of subsidy. Plan structures were also vague, and sometimes even wrong. It became impossible to tell the difference between reputable carriers, and insurance co-ops, which popped up quickly after the ACA Marketplace was opened to try and swindle buyers into cheap self-insured plans. Most, if not all of these companies folded within a year, leaving people with unpaid claims and no coverage.

But not only did the ACA make things more convoluted, warranting more broker involvement, it also backwardly contributed to the ease with which insurance brokers have been wiped out on a massive scale. (It is estimated that roughly 200,000 brokers were forced out of business by the ACA). By the government requiring people to get insurance or face a penalty, and allowing them only one way to do it, insurance carriers no longer relied on agents to drive business. They no longer needed to develop new product, and entice agents to sign on to sell it. Their products were listed in healthcare.gov, with people being forced to chose one or pay, rendering the agent’s role useless to a carrier—but certainly not a buyer as there was even more than ever for an agent to walk clients through.

Insurance carriers pay commissions to agents based on product type and volume of sales. With the ACA not properly accommodating for claims losses caused by forcing carriers to increase the amount of risk they took on in preexisting conditions, cutting commissions to agents was one of the first budget slashes. After decades of commission guarantees, a whole industry of insurance professionals saw their livelihoods done away with—with the ACA completely overlooking any kind of protection for this enormous job loss, and the GOP plan also not including any kind of language referencing agents.

What will continue to be true however, is that insurance customers will need insurance agents. Their guidance and expertise will be crucial in navigating people from existing Obamacare structures into the mass enrollment of Trumpcare. And without proper protection by and for their industry, they will be added to the list of crucial healthcare elements that are no longer guaranteed in the age of Trump.

Image: Eva, CC-BY

Chloe Stillwell is a Nashville-based columnist focusing on politics, culture and feminism.