The Pennsylvania Association of Health Underwriters (PAHU), the state chapter of the National Assocaition of Health Underwriters (NAHU) recently sent an email to members outlining the organization’s stance on a number of legislative issues, including its concern that the role of the health insurance agent is not fully realized by many consumers or governmental leaders. What follows is the text of that email.

2009 – PAHU Priority Goals and Positions

PAHU supports ways to help the private sector insure more people.  While most accept the desirability of universal coverage, there is a clear difference between those wanting to expand the government’s role versus those (including PAHU) who want to make health insurance affordable by addressing cost issues as a first priority and letting government play a partnership role when it enhances the private sector and not replaces it. 

PAHU believes that the role of the insurance producer (broker) needs to be better understood because the agent touches all parts of health, the insurance companies, the health providers, and most important, the consumer.  The insurance agent is both advisor and advocate for his or her customers.

Support –

PA assistance to the free health clinics as they represent direct provision of health care to the needy, bypassing the red tape that hampers the system; Support allowing physicians to donate clinic services in exchange for professional education credits; Loan forgiveness and start-up assistance (perhaps in the form of grant money or tax credits) to providers that open practices in underserved areas, urban and rural.

Oppose –

Adoption of a single payer system for PA because that will lead to rationing of health care and a huge cost shift to the taxpayers.

Support –

PA premium assistance program modeled on HIPP where the government may help a low wage earner with his/her share of premium costs and keep them in the employer group

Oppose –

Mandatory medical loss ratio as it imposes an arbitrary ratio and discourages market forces to have more of the premium dollar going to claims. Carriers should be able to price their product based on a loss ratio. Consumers should be able to decide whether or not loss ratio is important.

Support –

Agents marketing CHIP legislation because agents are an efficient and cost effective way to reach kids that are eligible for CHIP yet are not enrolled.

Oppose –

Doubling of adultBasic enrollment as it would further erode the employer-based system and frankly be a Budget-Buster for years to come.

Support –

Re-authorization of the PA Health cost Care Containment Council (PHC4) as a quality and cost transparency tool

Oppose –

Imposition of Managed Care Organization “assessment/tax”

Support –

Adverse outcome legislation as a way to heighten provider best practices since if insurers do not pay for preventable mistakes, costs to the health insurance system will decline

Support –

Tax credits for long-term care insurance as an incentive for employers to offer long-term care insurance to employees; Promote public awareness programs on the new Long-Term Care Partnership program as way to reduce growth in Medicaid long-term care expenditures.

Support –

Mini-COBRA for employees who lose their jobs in 2-19 size groups. 

Oppose –

Consolidation of school benefit programs into one state-run plan because school districts’ abilities to curb heath care costs such as through the consortia will be compromised

Support –

Tax incentives for Health Savings Accounts to promote individual choices in health care decisions; Support incentives for employers to help defray employee deductible costs and encourage enrollment by younger ‘Indestructible’ who are now free-riders

Support –

Tax and premium incentives for specified wellness programs adopted by the employer

Oppose –

Creation of a distinct Office of Consumer Advocate for Health Insurance separate from the Insurance Department’s traditional role as consumer advocate

Do not oppose –

Annuity suitability legislation

Support –

Greater transparency of health provider pricing via PHC4 so that people can see what providers charge via the Internet

Do not oppose –

Changing dependent age to 30

Support –

Exploration of a risk pool modeled on the (auto insurance) Assigned Risk Program; PA should establish a risk pool to siphon off the uninsurable population (such as those retiring before they are eligible for Medicare)

Support –

Reducing demand for medically unneeded tests by addressing the malpractice issues that encourage providers of health care to request additional tests to avoid potential legal issues; Support tort reform such as the Fair Share Act to replace joint and several liability where everyone gets sued to comparative negligence

Support –

Incentives for greater use of electronic records and electronic Rx to reduce duplicative facilities and treatments coupled with tort reform

Support –

Premium tax holiday for new health insurers coming into the PA marketplace

Support –

PA should mount a consumer education campaign to familiarize people with how health costs increase because of over-utilization and the need to be rational consumers of health care, what questions to ask and how to compare services and prices modeled on the Financial Literacy Campaign

For more information on any of the above, contact Vince Phillips, PAHU lobbyist, at 717/232-0022 or aol[dot]comvince[at]vphillipsassoc[dot]com">vince[at]vphillipsassoc[dot]com