Legislative Breaks and Labor Day BBQs

It’s heating up over here!

By Dawn McFarland

Is anyone else curious what happened to July? I remember being excited for the 4th of July holiday. Next thing I know it’s August and I have an overwhelmed inbox and certification reminders from every.single.carrier. Yep, it’s that time for those of us who write Medicare business. (I know, First World problems, and I am grateful for them).

In case you haven’t heard, there is an upheaval with the new Centers for Medicare and Medicaid Services (CMS) marketing rules. A change.org petition (https://bit.ly/3dm9rJk) is circulating for signatures. Agents are concerned that Medicare beneficiaries are going to have even less access to resources. Similar to what happened with the Broker Compensation Disclosure in the Transparency Act, CMS has not issued parameters for the new rule (finalized on May 9 to go into effect Oct. 1). NAHU and other stakeholders are asking for at least a delay in implementation. As professionals we are required to abide by the compliance rules put in place so I highly recommend you be prepared for the Oct. 1 deadline. Many CRM’s and FMO’s are already preparing to have materials available for agents.

Read more of NAHU’s comments to CMS here: https://nahu.org/membership-resources/medicare-portal/compliance. As I write this piece, the fight to remove independent agents from the definition of third party marketing organizations (TPMO) continues. By the time this article is published we should have more clarity of CMS expectations of independent agents.

In the queue
Another question that will likely be answered when this article hits: Will the Inflation Reduction Act (the Build Back Better Act’s skinny sibling) pass in the House and get signed by the president?* If it does, our government will be able to negotiate Medicare drug prices; there will be an inflation cap on carriers for prescription drugs; and the ARPA subsidies for individuals and families will be extended for 3 more years — just to name a few things included in the healthcare space. It is also being touted as one of the biggest efforts for our climate in history.

NAHU’s August recess talking points focus on passing the Commonsense Reporting Act of 2021 (S. 3673/H.R. 7774), with an explanation of how this method of employer reporting will help avoid unintended consequences if the family glitch proposal goes through.

The California Legislative session ends August 31. Stay tuned for how the remaining 800 pieces of legislation shake out. The Office of Health Care Affordability was authorized in the state budget and is contained in the newly named Department of Health Care Access and Information (HCAI). Theoretically the purpose of this board will be to create and enforce healthcare cost targets. It will be important to note who will be appointed to the board in late 2023.

And while single payer legislation was defeated this year, we heard there will be another bill introduced as early as next session (beginning Dec 5). November elections are fast approaching and California legislators are feeling tousled. Many are looking to step away. While this brings in new faces, new perspectives and fresh energy, it also brings the need for educating new lawmakers so they avoid unintended consequences while shaping healthcare.

Guess whose job it is to do that education — yep, you guessed it — OURS! Legislators need industry professionals to help them understand what is actually happening in the market. There are 13 AHU chapters (cahu.org/chapters) up and down the California coast. Please reach out to get connected and be prepared to join us in Washington D.C. in February 2023 and Sacramento in May 2023.

Other market news
Rate increases seem to be on the rise. The good news is — the California market is still performing beyond national markets with price and choice. Covered California released an average increase of 6%, which is 4% less than the 10% national average. Some areas are also getting Aetna as a carrier option in the IFP market.

And finally …
As always, I implore you to JOIN the National Association of Health Underwriters (nahu.org) — soon to be National Association of Benefits and Insurance Professionals — NABIP). Joining NAHU automatically makes you a member of the California Agents & Health Insurance Professionals (CAHIP formerly CAHU) AND a member of your local chapter. Ha, say that 10 times fast! If you already ARE a member, thank YOU. Please invite a colleague to join. We must always be growing to maintain a strong voice. Our voice DOES matter — I have seen it firsthand.

As another California summer comes to a close with the Labor Day weekend BBQ on the mind. Do your best to stay present and remember what really matters. I remain “Hopelessly Devoted” to you and close with a nod to the one and only Vin Scully, “As long as you live, keep smiling because it brightens everyone’s day.”

DAWN MCFARLAND is VP of legislation for CAHU (now known as CAHIP) and president of M&M Benefits Solutions in Los Angeles. dawn@mnmbenefitsolutions.com
Tel: (805) 701-1229

* Update – Inflation Reduction Act signed by President Biden – watch this NAHU Healthcare Happy Hour Podcast to learn the details and what that means for you and your clients. https://nahu.org/membership-resources/podcasts/healthcare-happy-hour