Healthcare Update August 2011
The Michigan Business and Professional Association (MBPA), along with its sister group, the Michigan Food and Beverage Association (MFBA), work diligently to keep you up to date on the happenings in Washington, D.C. and Michigan as our new healthcare law continues to move forward. We value our relationship with the agent community and work towards helping you maintain your client base. Since the agent community has been under attack, we are here to lend a hand when needed most.
Federal Activity
Our government relations team has been working full speed ahead and lobbied diligently against the legislation to form a universal healthcare plan since the first discussions of such a proposal began. We continued the charge as President Obama signed the Patient Protection and Affordable Care Act on March 30th, 2010, to ensure our members are able receive the same great quality service by their agents. We have had countless meetings with both key federal and state officials that are responsible for making critical decisions on how Michigan interacts in the federal healthcare exchange. Most recently on July 13th, 2011 we testified in front of a Senate Health and Insurance Joint Committee on the need for a state run healthcare Exchange. Michigan must retain power over what happens with our healthcare, from providers to agents.
Please see below for recent updates and notes pertaining to our new healthcare law, and visit our website www.michbusiness.org , and click the National Healthcare tab for more detailed information. In addition, please use our website to find more helpful links understanding your healthcare options, obligations, and frequently answered questions.
- On July 11th, 2011 the federal Secretary of the Health and Human Services (HHS) released much sought after information in regards to initial proposed regulation governing the health benefit exchanges under the PPACA. Highlights are:
- Proposes a pathway for states to ensure that individuals and small groups have access to information about agents and brokers, should they wish to use one, on state exchange websites and in other publicly available materials.
- Requires that navigators, including agents and brokers acting as navigators not receive commissions or other payments directly from health insurance carriers, but specifies that these requirements only apply to health insurance exchange products.
- Navigators must meet any licensing, certification or any other standards prescribed by the state or exchange, which will allow the state or exchange to enforce existing licensure standards.
- A State does not have to be completely ready for federal certification as an independent state exchange on January 1, 2013. They would in turn be provisionally certified by HHS instead.
- Repeal of the 1099 reporting requirement: Under the reporting requirement, that was set to begin in 2012, all companies would have been required to issue a Form 1099 to any individual or corporation from which they purchased more than $600 in goods or services in a tax year. The expanded reporting requirement would have resulted in an unnecessary and unfair burden for small businesses/your clients.
- Mission critical: Michigan’s role in the Exchange-Keeping Insurance Agents: MBPA was recently involved in assisting key state officials in how our State will function within the healthcare Exchange. A compilation of discussions from all stakeholder meetings is set to head to Governor Snyder soon for his thoughts and approval as we move forward.
- Michigan continues to remain one of 20 states challenging the federal healthcare law under the direction of our Attorney General Bill Schuette.
- Effective January 1, 2012: The new law provides incentives for physicians to join together to form “Accountable Care Organizations.” In these groups, doctors can better coordinate patient care and improve the quality, help prevent disease and illness, and reduce unnecessary hospital admissions. If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save.
- Accountable Care Organization: A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of care patients get. The organization’s payment is tied to achieving health care quality goals and outcomes that result in cost savings.
- Accountable Care Organization: A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of care patients get. The organization’s payment is tied to achieving health care quality goals and outcomes that result in cost savings.
- Reminder: The Affordable Care Act imposes an excise tax on employers that do not satisfy the market reform and consumer protection provisions of the Affordable Care Act equal to $100 per day for each affected participant, up to a maximum fine for unintentional failures of $500,000 per taxable year. The IRS (or HHS) has discretion to waive the tax in whole or in part to the extent the failure was due to reasonable cause and not to willful neglect, and small employers with no more than 50 employees may be exempt from such tax with certain exceptions.
Michigan Activity
It has been a busy spring and summer for our government relations and the Associations management team as we work with state government to forge a direction for a Michigan Health Exchange. Representing our over 20,000 member businesses and our agent partners we have been heavily involved in the following activities.
Health Insurance Exchange Planning Work Groups
The MBPA and MFBA had representatives on four of the five exchange workgroups sponsored by the Michigan Department of Community to provide input regarding the creation of a Michigan Health Exchange. Our work group members spent over 50 hours to provide critical stakeholder input related to the design and operation of a Michigan based health exchange. The work group process resulted in more that 50 consensus based recommendations regarding the structure and composition of the exchange governing board; potential financing options for the exchange; certification process for qualified health plans offer through the exchange; and recommendations for a technology infrastructure to support the exchange. These recommendations were presented in July to the Senate Health Policy and Insurance Committee, where the MBPA and MFBA testified as well.
Meetings with State Agencies
The Associations have had several meetings with the Department of Community Health and the Office of Financial and Insurance Regulation which will have the responsibility to implement any legislation for a Michigan based healthcare exchange. Representing our members and independent agents we presented these State agencies with our core principles and recommendations for Michigan’s exchange which included allowing independent agents to sell and service exchange individual and group plans (click here to view core principles).
Working with Business Groups
The Associations have partnered with several Lansing based business organizations to educate the legislator regarding the key elements of the Patient Protection and Affordable Care Act (PPACA). Additionally a health insurance exchange primer document has been developed by the group to assist in our lobbying efforts.
Supporting the Legislative Process
Our Lansing government relations team is aggressively working with the leadership of the Senate and House to ensure that our recommendations for Michigan’s Healthcare Exchange are understood and included in exchange legislation. Meetings have been scheduled with both the Senate and House Health Policy Committee Chairperson and we recently testified at joint Senate Health Policy and Insurance Committee hearing regarding for formation of a Michigan Healthcare Exchange (click here to view our testimony). We will be testifying at all future hearings in support of our members and independent agents. Additionally we remain in constant contact with your independent agent associations to insure coordination of issues critical to the agent community.
Tools for You as an Agent.
Your clients need to understand PPACA and its impact on them and their employees. We have a PowerPoint presentation (click here to view) for your use as well as an overview of the PPACA (click here to view).
Please know that we are committed to you and our members as we aggressively lobby here in Michigan.