Insurance Specialties

AC-T put too much emphasis on view of Navigators

Article after article and one editorial after another were from the point of view of the Navigators … the community organizers of the health insurance world.

I object to the manner our paper has reported on the Affordable Care Act’s (Obamacare) enrollment process. This is not about the problems of the exchange or the overinflated numbers, I am referring to the non-profit community based firms doing the enrollment.

Article after article and one editorial after another were from the point of view of the navigators … the community organizers of the health insurance world. These unlicensed people were hired by well-intentioned nonprofits, given perhaps 30-hours of training, then sent on their way to assist individuals on the exchange. They were subject to minimal or no background checks, and I am pessimistic regarding the possibility of identity theft. It appeared our paper (and other media outlets) spent an inordinate amount of time reporting how these (and only these) organizations could help people enroll in a health insurance plan.

From my perspective, that would be similar to high school newspaper reporters writing professionally for a newspaper about political and local events. As a professional insurance broker with 30 or more years of experience, I take offense at this slight. The WNC Association of Health Underwriters (www.wncahu.org) has many exchange certified agents that could have navigated and given professional advice. As licensed professionals, we are allowed to advise and receive payment for that advice — whereas the ACA did not allow navigators that role. If anyone reading this was directed in any way toward a plan, or advised a particular plan met your (or your family’s) needs, that navigator broke the law. The title navigator defined their abilities; to help individuals input information, verify the information was correct, and move them through the website (navigation only, no driving or directing). The best news is, if the plan you purchased because of that advice is not what you thought … too bad. As governmental representatives, they cannot be sued for their actions.

As to the wisdom of the ACA, the verdict is still out. I believe that once those with Bronze and Silver plans realize there can be up to a $6,300 single and $12,600 family out of pocket for a major illness, there will be uproar. Small group, defined as under 50 employees, also has issues, not the least of which is maximum deductibles, minor rate differences between smoker and non-smoker, and too few age bands. For the business owner, there is no composite rating, so older employees are charged much more than the younger. Sounds fair, you say? Well, since most employers do not pay all of the cost but contribute either a percent of premium or a defined amount, the older employee is left paying a significantly higher amount than the younger. If this isn’t an unintended consequence, I’m not certain what it would be called.

Then there are the taxes and fees levied on medical device manufacturers and the pharmaceutical industry, to name but two affected industries, all of this so those earning between 100 percent and 400 percent of federal poverty levels get an insurance subsidy. How many stories have you heard about young people paying $26 to $50 for “good insurance”? The real cost is somewhere from $120 to $250 per month; guess who is paying the balance?

Insurance has nothing to do with health care; it is but a mechanism to help pay for the cost of care. Insurance shifts the risk from the individual to the insurer; but the insurer in no way gives, provides or recommends care.

As we move forward, if advice on plans is to be given, I suggest those reading seek an insurance professional that has the training, expertise and credentials to help. I do not care if the need is for individual, small group, large group, medical, dental, disability, life, or any line of coverage. We are experienced and knowledgeable with far more than a mere 30 hours of training. By the way, the North Carolina Association of Health Underwriters will be holding its annual symposium shortly to provide this year’s 12-hours of continuing education credits (plus an additional 3-hours of ethics). Are navigators as well trained and informed? I wonder, too, about the depth of the reporting since members of agents’ professional organizations such as NAHU and NAIFA were rarely, if ever, soughtfor comments. I challenge the paper to more in-depth, professional reporting by seeking professional and seasoned opinions … not just those of academics and community organizers.

Block is a partner in Pine Street Insurance Services LLC and the current federal law and legislative co-chair for the N.C. Association of Health Underwriters.

ORIGINALLY PUBLISHED IN THE ASHEVILLE CITIZEN TIMES - April 6, 2014