The Medical Loss Ratio (MLR) bill is back in the Senate after along hiatus, or death, as some might say, in committee lastyear. 

Sens. Mary Landrieu, D-La., Johnny Isakson, R-Ga., Mark Begich,D-Alaska, and Lisa Murkowski, R-Alaska, reintroduced lateThursday a bipartisan proposal writtento preserve the role of health insurance agentsand brokers. The senators are expected to have a statementlater today.

The bill is called the Access to Independent HealthInsurance Advisors Act of 2013. It is awaiting a numberassignment. Last year, current NAIC CEO and past senator, BenNelson, D-Neb., was a co-sponsor.

Sen. Landrieu chairs the Committee on Small Businessand Entrepreneurship, which studies the issues relating to Americansmall business enterprises.

The Senate version of the MLR bill would change the provision inthe Patient Protection and Affordable Care Act (PPACA) tospecifically exclude agent compensation from the MLR formula, butchiefly in the individual and small group markets.

The MLR rule, which went into effect on Jan. 1, 2011,mandates that at least 80 percent (individual and small group) or85 percent (large group) of premiums collected by the carrier mustbe spent on "health care quality improvement."  

The law, as written by Congress, did not statutorily address howto classify independent agent compensation under the MLR formula.However, through the regulatory process, the Department of Healthand Human Services (HHS) ruled that not only was agent compensationincluded in the MLR formula but it was included as a part of the"non-claims costs" category, the agent community pointed out.

The Senate bill is not up on government tracking of bills, yet,but last session'sis http://www.govtrack.us/congress/bills/112/s2068 

The MLR provision limits administrative costs in healthinsurance premiums to 15 percent for large groups and 20 percentfor small groups. As a result, agents say their commissions havebeen cut by up to 50 percent on health insurance products.

"The (MLR) requirements contained in the Patient Protection andAffordable Care Act continue to have a devastating financial impacton the country's approximately half-million licensed professionalhealth insurance agents and brokers, as well as on all of theiremployees and their millions of employer and individual clients,"stated Janet Trautwein, CEO of The National Association of HealthUnderwriters (NAHU).

Trautwein explained that the MLR requirements significantly andnegatively impact access to health insurance agents and brokers atthe very time our economy is the weakest and health care consumersneed the most help.

She noted that the Congressional Budget Office(CBO) reported that agents and brokers often serve as defacto human resources departments for many small firms —negotiating premiums, processing claims and enrollingemployees. 

"Without agents' expert advice, many individuals and businesseswill end up spending more for health insurance and receive lesscare," Trautwein warned.

"We support the bill and hope that it sees its way to the finishline, said Joel Kopperud, a key lobbyist for the Council ofInsurance Agents & Brokers (CIAB). He added that CIAB is veryconcerned about the premium increases that are around the corner in2014 and the impact they'll have on the small group market andcalled on Congress to do even more. 

"The carriers are pointing to the new 3:1 age bands and thedisproportionate health insurance tax, and there are reports thathospitals and provider fees are on the upward trajectory, and we'reconcerned about the impact these factors will have on consumers andemployers that are looking to do right by their employees. Membersof Congress need to quickly focus their attention on skyrocketingcosts and encourage employer-based solutions that have a positiveimpact on human behavior and keep costs down," Kopperudsaid. 

"We greatly appreciate Senators Landrieu and Isakson once againintroducing legislation to shelter agent commissions from thedetrimental Medical Loss Ratio regulations as part of theAffordable Care Act.  The MLR regulation has done greatdamage to our small business members and the customers they serve;and immediate relief from the regulation is necessary and is soundpolicy," stated Charles Symington, senior vice president,government affairs, for the Big I, the Independent Insurance Agents& Brokers of America Inc.

Mike Becker, vice president, federal affairs of the NationalAssociation of Professional Insurance Agents (PIA) stated that thisbill "removes artificial disincentives which could prevent licensedindependent insurance producers from continuing to provide a widerange of services for both individual consumers and the businesscommunity in dealing with the Affordable Care Act."

Becker also noted that PIA is optimistic for passage of Sen.Landrieu's bill, "as it is crafted in a way to avoid negativeimpact on the federal deficit." 

In the House, last session's bill became dormant and agents andbrokers are hoping it will be reintroduced. 

The old H.R. 1206 was sponsored by Rep. MikeRogers, R-Mich., and Rep. John Barrow, D-Ga., and had scores ofco-sponsors. Rogers' office did not return a query by presstime onefforts planned this year in the House.

Rep. Marsha Blackburn, R-Tenn., vice chair ofthe House Energy and Commerce Committee told NAHU at itslegislative conference on Feb. 27 to keep its eye onEnergy & Commerce as well as on Ways and Means for action thisyear on health reform policy change initiatives and other work onRepublican priorities, including the possible reinvigoration ofsome old business with agent-promoted legislation.