NU Online News Service, Nov. 19, 3:40 p.m. EST
A provision in the Senate version of healthcare reform legislation dealing with so-called "Navigators" that would be created to help people under the alternative "Exchange" market system has industry officials concerned.
The bill includes a provision under which the exchanges would contract with outside parties to engage in exchange-related education, marketing and enrollment-related activities.
Under the provision, insurance agents and brokers are expressly included in the list of individuals or entities contemplated as Navigators under the Act.
But the bill also requires the secretary of Health and Human Services to promulgate regulations that would apply to the state exchanges to ensure that any Navigator "is qualified, and licensed if appropriate"–language, which concerns one industry lawyer who asked not to be identified.
Of greatest concern to the lawyer is the fact that the HHS secretary is required under these provisions to "establish procedures under which a state may allow" (but is not required to permit) "agents and brokers to enroll individuals" in exchange plans.
The lawyer also noted as a "potential concern" the authority of the HHS secretary to issue "rate schedules for broker commissions paid by health benefits plans offered through an exchange" rather than permitting such commissions to be negotiated in the marketplace.
The legislation, the Patient Protection & Affordable Care Act, was unveiled late last Wednesday by Sen. Harry Reid, D-Nev., Senate majority leader.
It meshes provisions of legislation reported out by the Senate Health, Education, Labor and Pension Committee and the Senate Finance Committee.
It would impose new regulations on insurers, extend coverage to 31 million people who are not covered and add new benefits to Medicare recipients.
According to a Congressional Budget Office analysis of the bill, it will cost $848 billion over 10 years, but was projected to cut budget deficits by $130 billion. It would do so because the costs would be more than offset by new taxes and fees and by reductions in the growth of Medicare.
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.