Jul 30, 2019
The Senate will wait until after the August recess to vote on the Lower Health Care Costs Act, which was introduced by Sen. Lamar Alexander, R-Tenn., and Sen. Patty Murray, D-Wash. The bill includes the following provisions:
- Broker commissions: Require brokers to disclose compensation from insurers and other vendors, in writing, when an employer signs up for benefits
- Surprise medical bills: Ensure that emergency care and services like air ambulances are always considered in-network and count toward a patient's deductible
- Generics: Increase access to lower-cost generics by speeding up the FDA’s approval process
- Deals between hospitals and insurers: Ban clauses that prevent insurers from sending patients to lower-cost or higher-quality facilities for certain procedures.
- Gag clauses: Ban gag clauses that prevent patients and plan sponsors from accessing cost and quality data on health care procedures
- Claims data: Require insurers to share de-identified claims data if plan sponsors request it, so they can determine whether they are getting a good deal on their plan
Janet Stokes Trautwein, CEO of NAHU submitted comments in support of addressing surprise medical bills, high drug prices, and public health problems. She noted that brokers spend an extraordinary amount of time helping consumers with claims adjudication due to unexpected medical bills for emergency room care and ambulances.
She laid out the following arguments against a provision on disclosing broker commissions:
- Having more disclosure requirements would increase health costs and lower access to agents and brokers. Consumers who work with brokers statistically pay lower premiums
- The disclosure process is not compatible with how agents and brokers earn compensation. Agents are often unaware of their compensation until the end of the plan year
- In the small-group market, consumers pay the same for a plan regardless of whether they work with a broker. Also, broker compensation is virtually standardized among insurance companies
- If a broker fails to find the best plan at the lowest price, the client can easily sign a broker-of-record with another broker. The incentive here is to act in the best interest of the client
- State licensure laws already require disclosure of compensation to the client. These requirements have been adopted encompassing the National Association of Insurance Commissioners’ Producer Licensing Act. Further, under ERISA, insurance carriers with plans for groups over 100 must provide information about agent compensation
