Transcript Working with Congress: A Primer on Being an Effective

WORKING WITH
CONGRESS
A Primer on Being an Effective Citizen
Lobbyist
Presented by Janet Trautwein, Peter Stein, John Greene and Adam
Brackemyre
National Association of Health Underwriters
Why are We “Lobbying”?
• NAHU members are a valuable resource to the
policymaking process
• We are all joined in a growing trade association
because we care about our industry and its future
• We have distinctive knowledge and understanding of
the realities of health care markets
• We must interface and build relationships with elected
officials so that they make policy decisions that are
based on how we make health care work on a daily basis
What to Expect in a Meeting
• Health care staff people who advise Member of
Congress on health and health insurance issues can be
new to the subject matter
• Capitol Hill staff in personal offices often cover a wide
variety of issues for their Member
• It is up to us to help Members and staff understand
how health care delivery works in the real world, and
how different policy ideas might affect the populations
that we serve
What to Expect in a Meeting
• Likely to meet with staff, and perhaps not Member of
Congress / Senator – this is positive
• Meetings usually last no more than 25-30 minutes
• Members of Congress have very crowded and busy
schedules, but they rely on staff to be their eyes and ears on
their policy portfolio. So get to know and develop a working
relationship with key people on their staff.
• If Member is able to meet with you, it is not uncommon for
him/her to be late or to have the meeting interrupted
• Always keep in mind that since this is your livelihood, you
probably know a lot more about health insurance than the
staff or Member – help them learn more
The Approach: Quick Prep Items for your
Meetings
• In whatever team of colleagues you are joined
for your visits, it is helpful coordinate among
yourselves topics to be covered and assign main
spokespeople
• Try to determine how knowledgeable of health
care the staff or Member of Congress is – know
committee assignments, sponsorship /
cosponsorship of measures, votes on major bills
of interest
What to Expect on a Visit
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Since both your and their time is valuable, be
prepared to state a clear and concise
objective in discussing our issues
Explain why the issue is important to you
personally (wear various hats: as producer,
parent, as club member) and try to link the
importance to the elected official’s district /
state (“All Politics is Local”)
If you don’t know an answer – that’s OK!
Make a note and get back to them
Election Results
• Changes to Congress
Factors to Consider:
o Historic number of new legislators
o Tremendous turn-over in staff and committees
o Need to off-set repeal changes with other spending cuts
o House actions will be tempered by tight Democratic
majority in the Senate and President Obama
o GOP will need to balance delivering on promises now and
goals for 2012
• Changes to States
o New Governors
o Potential change for 20 + state insurance commissioners
o Historic number of new state legislators
MLR
• Current MLR requirements are significantly and negatively impacting
access to health insurance producers
-This is loss of a vital consumer service
• MLR is forcing insurers to eliminate key business areas that reduce costs
like claims management, fraud prevention and disease-management and to
pull out of some markets
-This means consumers may pay more or be unable to afford coverage
• Many agents are seeing a net reduction of their business incomes of 3050% or more.
-This means fewer will be able to stay in business and many will have to
begin reducing services to clients and cutting jobs
NAHU supports exempting pass-through fees collected for independent
agents/brokers from the MLR calculation
Role of Agents, Brokers and Consultants
• We support the continued involvement of
professionally licensed benefit specialists before,
during and most importantly, after the purchase
of coverage, regardless of the place of purchase.
• We oppose the exclusion or limitations on the
use of licensed benefit specialists in any setting
including state or federal exchanges created as a
result of PPACA.
Employer Issues
• PPACA will limit the ability of many employers
to afford to offer coverage to their employees
and is contributing to our nation’s current
economic uncertainty and limited job growth.
• Erosion of the employer-based system of health
insurance will make health coverage more
expensive for millions of Americans.
Employer Issues
• We support repealing the PPACA employer mandate
provisions or at minimum, the affordability provisions.
• We support increasing the maximum waiting period
to at least 120 days, auto enrollment consistent with
waiting period, and preserving ERISA
• We oppose the current 105(h) non-discrimination
requirements as they apply to small employer groups.
Market Reforms
• We support:
A national open enrollment period with late enrollment
penalties for child-only plans.
Loosening restrictions on the requirements for grandfathered
plans.
Annual enrollment periods with late enrollment penalties.
A transition period for the shift to new rating structure and
expanded age rating bands
Eliminating the deductible cap on small employer health plans.
Raising the FSA limit to $5000 in 2013 and tying future annual
increases to the medical inflation rate
Eliminating the ban on reimbursing OTC drugs through FSA,
HRA, and HSA funds
Making Coverage Affordable
• We support:
Allowing federal premium subsidies to be used to
purchase coverage both inside and outside of the
exchange
 Improvements to the small business tax credit
program
Same tax benefits for individual health consumers
as the self-employed but not at the expensive of
removing the tax-exclusion for employer sponsored
benefits
Containing Health Care Costs
• We support:
 Expanding access to wellness programs and
wellness discounts
 Medical liability reform
 Provider quality and cost transparency
 Federal initiatives to encourage provider use of
best-practice guidelines and evidence-based
medicine
 Payment mechanisms designed to reduce the
cost of care
Senior Issues
• We support:
Congressional action to restore funding cuts
from PPACA on Medicare Advantage
 Restoring the Open Enrollment Period for
Medicare beneficiaries
 Repeal of the Class Act, an under-funded
government-run long-term care benefit
program to be replaced with incentives to
purchase long term care insurance