Health Insurance Agents Role in Minnesota Health Care Reform for 2010 Greg Dattilo, CFP, CEBS Dave...

Health Insurance Agents’ Role in Minnesota Health

Care Reform for 2010Greg Dattilo, CFP, CEBS

Dave Racer, MLitt

www.freemarketheatlhcare.com

Today’s Agenda

Where we are today

Federal reforms

Going on the offense in Minnesota

(c) 2009: freemarkethealthcare.com2

We the People

“For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies…”

President Obama-2009 Inaugural


Health Reform#1 Domestic Agenda Item

Health Care Reform: 2009

Why reform it?

What needs reform?

When does it need to happen?

Who will do it?

(c) 2009: freemarkethealthcare.com

4

What is this crisis?

Quality of care

Access to health care

Uninsured

Spending

Cost of care


Patients as consumers: Insured

and “uninsured”

Doctors &hospitals

Payers

Provided care

Decided what to buy and from whom – Options for low-income

Paid catastrophic claims: They were insurance companies

Paid the first dollars for their own health care

How people bought health care pre-1966


48%Out ofPocket

6

Payers

Providers

Patients

Decide coverages

Managing physicians& their practice

May or may notcomply

But they will spend, spend, spend

U.S. Health Care Model

2009

How people have bought health care since-1966


12%Out ofPocket

7

Subsidies for "poor"

Patients do not know the cost They do not pay the bills Health care considered a right

We adopted the entitlement mentality


Politicizing health care

President Lynden Johnson (Democrat): 1965

President Richard Nixon (Republican): 1973

President William Clinton (Democrat): 1993

President George Bush (Republican): 2003

President Barack Obama: (Democrat): 2009

Every state legislature and governor


Everyone wants to know what will happen

Total federal government takeover?

No federal action at all?

Sending it back to the states to do real reform with or without federal mandates?

What do Minnesota agents do now?


The world of the health insurance agent


Insurance Companies

Health Care Providers

Health Care Banking

Government

Popular Perception

Uninsured

Employers

Employees

Uninsurable

Low-Income

Individuals

Seniors

11

Private insurance will spend…

$879 billion in 2009

(c) 2009: freemarkethealthcare.com12* Centers for Medicare/Medicaid 2009

Voluntary vs. Involuntary

170 Million Americans are covered under private health plans, almost all voluntarily purchased

Auto liability insurance – 14.6% non-compliance

Income taxes – 14.7% non-compliance

Health insurance – 15.4% uninsured


Coverage, by category*

Medicare, aged 65 and over

Medicare, under age 65

Medicaid, CHIP, Military, VHA, and other government programs

2009 CHIP Added

Total Covered - Gov

34 million

7 million

58 million

4 million

103 million

(c) 2009: freemarkethealthcare.com* Congressional Budget Office-12/2008

US Population- 9:00 am-9/30/09: 307,585,235

} Cost Shift$89 Billion

14

Where Congress is leading us

Community rating

Guarantee issue insurance

Mandated coverage

Government option health plan/Co-ops

Health Insurance Exchange

Squeezing money from Medicare & Medicare Advantage

Federal Health Board


Which of these will reduce health care cost and the uninsured?

But agents must do more than just say “No.”

15

Going on the offense in MinnesotaAgents Agenda -2010

Three primary goals

1) Reduce the current and future number of Minnesota residents who lack health insurance.

2) Protect Minnesota government from the immense fiscal burden it faces if more individuals, currently covered by private insurance, move to government health plans.

3) Stabilize today’s health insurance premium, and create premium price predictability for tomorrow.



1. Enrolling low-income individuals in private health insurance plans (a) Continuous coverage, guarantee issue health plan for individuals

being displaced from MinnesotaCare or other government-subsidized health plan.

(b) To assist individuals who are being displaced by budget cutbacks, create a referral system so that they are able to access a licensed professional health agent for assistance.

(c) Increasing affordability by making health insurance premiums tax deductible for individuals.



2. Changes to 2-50 small group definition

To solve problems of predictability and pricing stabilization, and increase the number of insured among employer groups.

Increase small groups, 2-50, to a larger number - group pooling as compared to experience rating, and/or other methodologies.



3. Protecting local school districts

Local school board control of their health benefits

Separately, or to pool their plans

A single statewide bureaucracy will ultimately reduce choice and increase cost to teachers and school districts



4. Full disclosure on MinnesotaCare limits

The application form for MinnesotaCare currently does not reveal the $10,000 hospital maximum

Licensed enrollers should explain affordable options from the private insurance market that offer comparable or greater benefits



5. Portability - Immediate conversion

About 50 percent of uninsured are between jobs

Allow immediate access to lower cost insurance plans as an alternative to an unaffordable COBRA/Minnesota Continuation plan



6. Create carrier choice for MCHA

Guarantee a right to choose a health plan without risk of being denied coverage through MCHA

Improved system for individuals as a reinsurance mechanism – allowing individuals to purchase a MCHA benefit set directly from the health plan of their choice



7. Create fairness in MCHA funding

Fully-insured Minnesotans pay 100 percent of the MCHA assessment

ERISA laws preclude large employers from paying their fair share of MCHA assessments

Fund MCHA with revenue from the Minnesota Health Care Access Fund



8. Encourage the use of HSAs and HDHPs Necessary for consumerism to flourish

We support a program to offer HDHPs with HSAs for government employees at the state, county, and local levels, as well as public education system employees



How to win for Minnesotans

Agents must be united, speaking with one voice and show strong resolve to move good legislation ahead in 2010

State legislators need to take the lead

There is much to be done – Let’s do it


Be involved


“For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies…”

President Obama2009 Inaugural

Be Involved


Four branches of governmentLegislativeExecutiveJudicial We the people

Health Insurance Agents’ Role in Minnesota Health

Care Reform for 2010Greg Dattilo, CFP, CEBS

Dave Racer, MLitt

www.freemarketheatlhcare.com

Health Insurance Agents Role in Minnesota Health Care Reform for 2010 Greg Dattilo, CFP, CEBS Dave...

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