Consumer Advocates Wary Of New Marketplace Rules For Brokers

By Michelle Andrews
Kaiser Health News, May 30, 2017

Signing up for coverage on the health insurance marketplace should be easier for some people this fall because new federal rules will allow brokers and insurers to handle the entire enrollment process online, from soup to nuts. Some consumer advocates are concerned, though, that customers going this route won’t get the comprehensive, impartial plan information they need to make the best decision due to the financial self-interest of insurers and brokers.

“Facilitating the participation of brokers and getting web brokers involved is a good thing for the market,” said Timothy Jost, emeritus professor at Washington and Lee University School of Law in Virginia and an expert on health reform. But there are risks for consumers. “If you’re enrolling with a web broker, you could see ‘best deals’ that often aren’t the best deal for you but are the best deal for the people who are marketing them.”

The staff at online health insurance broker eHealth is thrilled with the change.

“It’s a big deal,” said Nate Purpura, vice president of consumer affairs at eHealth. “Many people, including our CEO, have been to Washington, D.C., multiple times to explain the benefits of being able to help in this way.”

Its website, which works with 180 insurance carriers nationwide, offers about 75 percent of the plans that are available on healthcare.gov, Purpura said.

That’s a problem, say some policy analysts. Federal rules require web brokers to display basic information about all the plans that are available on the federal marketplace, whether or not they actually sell them. It includes the name of the plan and insurer that offers it, the type of plan — HMO, PPO, EPO — and metal level (bronze, silver, gold or platinum). Web brokers must also publish a disclaimer that says the website information about all the available marketplace plans might not be complete and provide a link to healthcare.gov.

But the information web brokers present about plans they sell and get a commission for may be much more comprehensive than the information provided about plans they don’t handle.

But some analysts remain concerned that details about how consumers’ privacy and security will be protected under the new system are still too vague.

“This is really sensitive information, people’s tax information, which needs to be highly protected,” said Jost. “There are a lot of concerns with confidentiality and privacy. I have some concerns about fraud.”

http://khn.org…

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The Centers for Medicare and Medicaid Services (CMS) announces streamlined direct enrollment process for consumers seeking Exchange coverage

CMS.gov, May 17, 2017

“This is another important step to help create stability in the health insurance market,” said CMS Administrator Seema Verma. “It is common sense to make it as simple and easy as possible for consumers to shop for and access health coverage. It is time to get the federal government out of the way and give patients the best tools to make their own healthcare decisions.”

https://www.cms.gov…

CMS Administrator Seema Verma is expanding the role of private insurance brokers, such as eHealth, in enrolling individuals in plans offered by the government ACA health insurance exchanges. Not only do the private brokers promote only selected plans on the exchanges, they obviously are motivated to push the plans for which they receive a generous commission, whether or not the plans selected are in the best interests of the enrollees. This does not serve the applicants well.

In her CMS release, Verma states, “It is time to get the federal government out of the way.” Her pro-privatization, anti-government ideology is so intense that she says that it is “common sense” to add additional, wasteful private administrative services with these outside brokers, paying them fees with our tax money, and yet depriving enrollees of the full informational services that our current government-operated exchanges are providing.

Worse services, piling on of administrative excesses, and diverting public money to private vendors are a terrible price to pay simply to please the anti-government bureaucrats that are filling the positions of public trust in this administration.

In a recent Quote of the Day, it was recommended that her boss, HHS Secretary Tom Price, be replaced based on the potential havoc created by his adhering to his nutty anti-government ideology. She should be replaced for the same reason as well – ASAP.

This comment is the opinion of the author and is not an official view of Physicians for a National Health Program.