The Affordable Care Act’s Special Agents

Janet Trautwein
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By Janet Trautwein

Last month, the Affordable Care Act’s insurance exchanges opened for business. America’s 32 million uninsured — as well as the roughly 9 million people who secured health plans through the online marketplaces this year — have a few more weeks to select a policy that will cover them in 2016.

Janet Trautwein
Janet Trautwein

Agents and brokers can help consumers understand the options that are available and get the coverage they need. They’ve been matching consumers with appropriate coverage for decades. They’re our nation’s best hope for getting the millions of uninsured Americans covered.

Health insurance is a complex product. Even for industry experts, it can be difficult to find the right plan at the right price.

Agents’ and brokers’ ability to do just that is becoming even more valuable as the cost of coverage grows. Next year, average premiums for silver plans on the exchanges — the most popular coverage option — will increase by up to 10 percent. Premiums for less-generous bronze plans, which cover a smaller share of patients’ health costs, will surge by 11 percent.

Health insurance is growing more expensive because medical care is growing more expensive. Prescription drug costs shot up 13.6 percent between 2014 and 2015. Medical costs increased 6.8 percent in 2015 and are projected to jump 6.5 percent next year.

Agents and brokers have been able to shield their clients from some of these trends. According to research from the University of Minnesota, premiums are 13 percent lower in counties with the greatest concentrations of brokers.

Agents don’t just save consumers money — they also help patients with claims or reimbursement issues following enrollment.

Furthermore, agents are familiar with the details of plan and can help an enrollee find a plan that fits his or her specific health needs. And brokers are legally required to have liability insurance, which protects consumers if there are any errors in the enrollment process.

Agents and brokers have already proven essential to the exchanges. They’re responsible for about 40 percent of existing sign-ups through the Affordable Care Act’s marketplaces. In Kentucky alone, brokers helped 55,000 people enroll in exchange plans last year.

Without brokers and agents, exchange enrollment would plummet. That would be disastrous. The exchanges are counting on high levels of sign-ups, particularly among the young and healthy. Insurers need their premiums to offset the costs of providing care to those who are older and sicker. If enrollment is insufficient, the marketplaces will quickly become insolvent.

As the Affordable Care Act matures, the enrollment process is destined to change. Agents and brokers can ensure that declining enrollment and consumer confusion are not among those changes.

Janet Trautwein is CEO of the National Association of Health Underwriters.



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