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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
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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 • 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: • Historic number of new legislators • Tremendous turn-over in staff and committees • Need to off-set repeal changes with other spending cuts • House actions will be tempered by tight Democratic majority in the Senate and President Obama • GOP will need to balance delivering on promises now and goals for 2012 • Changes to States • New Governors • Potential change for 20 + state insurance commissioners • Historic number of new state legislators
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 30-50% 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 MLR
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.
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 Market Reforms
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