MICHIGAN ASSOCIATION OF HEALTH UNDERWRITERS

Dear MAHU members,

On Friday, Pat Pennefather, Cathy Cooper, Gary Reed and I had a meeting with Commissioner Ken Ross and Deputy Commissioner Joan Moiles to discuss the implementation of various aspects of PPACA. We discussed the following areas:

Health Insurance Ombudsman: This is a work in progress that hasn’t had very much movement as of yet due to more pressing issues. We took the time to explain that members of MAHU act as this for our clients everyday and that we would really like to be involved in the development of the position within OFIR

Minimum Loss Ratios: Commissioner Ross indicated that they are still waiting on the development of this data from both HHS and NAIC. We expressed that this is of great concern to MAHU members since this is how we are compensated for providing the service. We told him that the NAHU leadership has been working closely with HHS in the development of what goes into the MLR calculation.

High Risk Pool: We were informed that an RFP is going to be going out next week to interested parties which appear to be the HMO plans and BCBSM. The time allowed for response has been shortened due to the time requirements for the establishment of the HRP. They hope to have chosen a partner or partners by Mid July. The HRP will abide by the PPACA guidelines with an estimated Open Enrollment to begin on September 1^st with coverage being effective on October 1^st. More details about the plans and particulars will be coming out once the RFP process is completed. When we asked about agent commissions for the HRP plans, we were told that the carrier or carriers that offer plans will use the same distribution channels they use now for Individual products. Some of the criteria for enrollment in the HRP is:

·       Person must have been without insurance for 6 months

·       They must be a legal resident of Michigan

·       They must have a pre-existing condition

·       They don’t have to have been denied in the standard market

·       There will be only one product design offered

When asked about how the funding would be done once the $140m of Federal money ran out, the Commissioner stated that they HRP would be limited to a certain number of slots within geographic areas and then would be closed down. We are concerned about whether this is allowed within the rules of PPACA. I’ll be sending an email up to NAHU to get some further clarifications on that issue.

Web Portal: The State and the Insurance carriers have the responsibility to provide HHS with the information that will be loaded into the Web Portal that is supposed to be up and running by July 1^st. They have no idea if this will actually be functional by the July 1^st PPACA deadline.

Exchanges: We have provided OFIR with information regarding the Utah and Massachusetts Exchanges as OFIR is currently awaiting additional guidance and regulations from the NAIC and OFIR. This is really in the infancy stages as far as they are concerned.  

MAHU will continue to keep you updated as progress continues on these topics.

Respectfully,

Michael A. Embry, RHU

Legislative Chairperson

Michigan Association of Health Underwriters               

Good Evening, 

We have concluded our 2010 NAHU Capitol Conference and I can say that this has been the wildest Conference that I’ve attended in the past 10 years I’ve been coming to DC to lobby on behalf of my clients and my industry! Over the past 3 days I’ve heard  many speakers on both sides of the Healthcare Reform issue and had meetings myself in the offices of Reps, John Conyers, Candice Miller, Dale Kildee, Fred Upton, Carolyn Kilpatrick, Mike Rogers and Senator Debbie Stabenow. The other members of our Michigan NAHU delegation held meetings with all of our other Michigan legislators.

What was so amazing in all of the meetings that I held was that every legislator had a different prediction on whether the Senate bill would be passed in the House. Even John Conyers’ office which is one of the most liberal Democrats believes that it will be a very close vote and may pass or fail by only one vote.

There are a number of dynamics at work here in DC and some of them are very interesting to watch. These are just the ones that I could find out from our meetings and discussions with our NAHU staff and lobbyists. There are probably other dynamics going on behind the scenes!

• All of the 39 Democrats that voted No on the original House bill have been called to the White House for a conference to discuss their position.

• The House Parliamentarian was called to a meeting in Speaker Pelosi’s office along with Rahm Emanuel to discuss the rules of the House.

• Blue Dog Democrat Bart Stupak is holding fast on his statement that he will not vote for the Senate bill unless they can “fix” the public funding of Abortion issue. He has 6 other Blue Dogs that are holding the line with him and that would be enough to defeat the Senate bill and the debate would be over.

• The Senate Republicans are planning on challenging every provision of the reconciliation bill as to it’s relevance to the budget.

• Some Democrats don’t like the Individual Mandate which is a part of both the Senate and House passed bills.

• The numbers still don’t add up to create the deficit reduction that the President states it will.

• If the House passes the bill, all of the “Sweetheart” deals would still be in the legislation!

The message that I took to the legislators is that my clients, colleagues and most of the citizens that I’ve spoken to don’t want the Senate bill passed in the House! Especially based on the promise that the Senate will “fix” the issues during the Reconciliation process.

If the Senate bill gets passed in the House then a number of things could happen as a result:

1.  The Senate could then declare victory and send the bill to President Obama for his signature and it would become law.

2.  The Senate could start the reconciliation process and then claim they can’t get reconciliation done and throw up their hands claiming they tried. Same result as # 1 above. They could then blame the GOP for stopping reconciliation from happening.

3.  The Senate could actually pass and approve the “fixes” they promise to address in reconciliation. Then that new bill would be passed in both chambers and would become law.

4.  The Abortion issue could be handled in a separate “side-car” bill that would be pulled form the Senate bill and addressed separately.

The President has told the House that he wants the bill passed by March 18^th before he leaves for Indonesia. Time is running out very quickly since it won’t be long before the Fiscal year is over and the 2010 budget year begins and this legislation must be handled in the current budget.

For those interested, the magic number to pass the bill in the House is 216 yea votes. As of the time I write this, the “nose counting” continues but so far it appears that Speaker Pelosi doesn’t have the votes.

I would ask that if you live or work in a Democrat’s district, please contact your Congressperson and tell them to stop this bill. It simple doesn’t deliver the needed reforms to reduce the costs of Health Care. It continues to be a partisan power grab!

If you’re not sure who your Legislator is, please visit www.house.gov and you can easily link to your congressperson’s website and sent them an email or call them and let them hear your voice!

Thank you for taking action in this very important debate. We are in the home stretch and can defeat this but it will take all the voices we can muster.

Looking forward to getting back to Michigan tomorrow.

Good Night,

Mike