Advocacy
Background
The health insurance market is rapidly evolving, and new options created by new rules for health reimbursement arrangements (including a new excepted benefits HRA), short term plans, health savings accounts and other products make the market even more dynamic. With many small employers still on pre-ACA grandfather or grandmother plans, the self-funded market will become increasingly important. Whether it is a lack of other affordable options, to assist with out-of-pocket costs, provide extra coverage, smooth out gaps in coverage between jobs, or to provide tools that can make consumers healthier and more financially secure, plan sponsors and consumers are demanding more options to fill diverse needs.
InsurTech startups and traditional insurers are also finding new ways to interact with their customers, improve customer experience, reduce claims costs, and more accurately assess risk.
But some state and federal regulators, and interest groups, are not happy with giving more freedom for startups and insurers to innovate and maximize consumer choice. They are trying to slow things down or shut down certain options entirely, impeding market growth and stifling welcome innovation.
For example:
The value of excepted benefits plans are questioned by a few regulators who want to substitute their judgement for that of consumers. They propose new restrictions on the sale of these plans.
Short-term plans are derided as “junk”. A number of states have moved to restrict short term plans blaming them for the failures of the Affordable Care Act.
States, particularly in the Northeast, are seeking new laws to restrict the availability of ERISA plans, especially those made available to small employers.
HRAs provide opportunities for employers to allow their employees to choose coverage that works best for them – in many cases for the first time. These choices need protection from efforts to restrict them by policymakers who think government knows best.
Some states have sued to eliminate Association Health Plans, another option for some employers.
HSAs have been falsely portrayed as merely offering a benefit for the healthy and wealthy. In truth, HSAs lead patients to be better health care consumers, although there is a need for better price and quality transparency.
These efforts to restrict choice and innovation are bolstered by well-funded and organized groups intent on “standardizing” choices so there are no options. In some instances, they argue there is no role for alternative products.
To fend off the attacks, there is an imperative to tell the consumer, the employer, and the innovator the story of the unique benefits these products provide to add value or to fill the access gaps to health coverage.
But policy and advocacy support for these products in the states and in DC has remained splintered, relying on individual company efforts to play constant “whack a mole” for their singular interests.
The Health Benefits Institute was created to counter the well-organized opponents and to provide the needed structure to amplify industry and allied voices that promote a better understanding of the these products among policy makers.
Opportunity
The Institute champions and advocates for empowered, educated consumers who enjoy the greatest number of health care options available.
The Institute also guides policy development, provides strategic counsel, communications, and representation before states and organizations like National Association of Insurance Commissioners (NAIC), National Council of Insurance Legislators (NCOIL), American Legislative Exchange Council (ALEC), State Policy Network (SPN). It initiates non-industry ally development that identifies and mobilizes third-party champions to support these positions.
The Institute’s focus is primarily in the states – where the real battles over insurance status, filings and product availability are fought on a daily basis. Our issue areas include:
Excepted Benefits (including specified disease, hospital or fixed indemnity, limited scope dental and vision, and other supplemental coverage)
Self-funded health insurance and Association Health Plans (with a focus on the small employer market)
Short-term health insurance
Account-based plans (including HRAs and HSAs)
The Health Benefits Institute educates legislators, regulators, consumers, and employers on the value these products bring to the market. And it works to combat efforts that seek to restrict choices and access to these products across all segments of the industry – individual, employer, and ancillary markets.
It’s important to realize that the Health Benefits Institute is not just another trade group. The Institute advocates for empowered, educated consumers with maximum options.
Legislators and regulators should not be substituting their judgment for that of an employer, employee, or consumer. Employers and consumers are demanding greater health care transparency, and the Institute will help lead the charge to break down barriers to necessary information. Our member companies will be dedicated to industry best practices that will continue to make the market better.
Products included in this industry include:
Health Reimbursement Arrangements (HRAs)
Health Savings Accounts (HSAs)
Short-term plans
Excepted benefits
Fixed indemnity products
Association Health Plans (AHPs)
Other self-insured plans
Resources
The Health Benefits Institute submits comments on state and federal regulation and legislation with the goal of ensuring consumer choice and promote fair standards. HBI also releases op-eds, issues and answers, and other pieces to promote innovative insurance.