You either believe or you don’t.  Mark me down as one who believes.  I believe in the fundamental promise of the United States, that all men are created equal (even when we fail miserably at that ideal), that we can govern ourselves (even when we elect less than competent leaders), and that we can structure a system to benefit most, if not all, of us.  And for that reason I work on legislative issues on both the federal and state level.  And that is why over 500 members of the National Association of Benefit and Insurance Professionals (NABIP) were in Washington DC last week.

This was our first completely in-person meeting since February 2020, the onset of COVID.  I wondered if citizens would again have full access to the House and Senate buildings post January 6, 2021.  I am happy to report that yes, I was able to wander around the halls of Congress.  I find the hours I spend in these buildings in serious discussions with our elected officials and/or their staffs, seeing the delegations of veterans, business representatives, and school children from around the country, or even just a casual encounter with a senator to be democracy affirming.

Our meetings with our elected representatives and their staffs are designed to reinforce our main message that health insurance is the way most Americans access and pay for health care.  We remind them that according to the 2020 US Census, 54.4% of the United States population is covered by employer sponsored group health insurance.  We want to make group insurance work smoothly and effectively.  With 10,000 Americans turning 65 every single day, our other main focus is to make Medicare work for our clients, their constituents.  We can get into the various bills and specifics, but the basics, access and payment for care, have remained the same for years.

Our timing was less than optimal this year as the Democratic members of the House of Representatives were on a three day policy retreat last week.  I was disappointed that we were unable to meet with Shontel Brown (D-OH) who represents much of Greater Cleveland.  I was fortunate to be included in a meeting with Troy Balderson (R-OH) of South Central Ohio.  Mr. Balderson and his legislative assistant, Megan Porter, were fully engaged in our conversation and well-versed on our issues.

There wasn’t anyone waiting to talk to this Congressman.

I also led a delegation to Senator Sherrod Brown’s office.  Senator Brown (D-OH) was meeting with several Cuyahoga County mayors so our group met with Francis Goins, a legislative aide who graduated from Shaker Heights.  Mr. Goins extended our meeting to 45 minutes.  He took notes and asked great questions.  Senator Brown has worked to resolve the Observation Trap and has sponsored legislation in previous sessions.  We are hoping the Senator will reintroduce legislation specifically addressing this issue.

Mr. Smith Goes To Washington premiered in 1939, a time when a Senate filibuster actually took effort and it was shocking to see a film that depicted both the American ideal and the reality of political corruption.  In 2023 the corruption is understood and the ideal is sometimes forgotten or ignored.  My annual participation in our organization’s Capitol Conference is confirmation that we can still achieve our ideals.

Dave

www.cunixinsurance.com

Pictures:

Mr. Cunix Goes To Washington – David L Cunix

The Loneliest Place in DC – David L Cunix

Winter in DC – David L Cunix

Those of us over the age of 60 are used to receiving an incredible amount of junk mail.  I am, of course, referring to the unrequested, unwanted, and unneeded solicitations from Medicare insurers, call centers, and marketing associations.  Many of these mailings are designed to look like official communications.  We also get unwanted solicitations on our home phones and cells.  And don’t forget the misleading television and radio commercials from the washed up athletes and C List celebrities.  It is hardly surprising that the Centers for Medicare and Medicaid (CMS) receives tens of thousands of complaints each year.  What is surprising are the steps CMS is taking to solve the problems.

Step One:  As per CMS: Agents must provide the following disclosure

• Verbally conveyed within the first minute of a sales call
• Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication (regardless of content)
• Prominently displayed on Third Party Marketing Organization websites (regardless of content)
• Included in any marketing materials, including print materials and television advertisements, developed, used or distributed by the Third Party Marketing Organization

Step Two: Recording Telephone Conversations

“Beginning October 1, 2022, for all 2023 activities, all TPMOs, including all third-party marketing/lead generation vendors, agencies, 1099 agents and brokers (captive, independent street brokers, TeleDigital agents, etc.), will be required to record all beneficiary calls (sales, enrollment, administrative, etc.) – inbound and outbound – in their entirety, with no exception. Other important requirements:

• Applies to all telephonic activities, even if it does not result in an enrollment.
• Requirement applies to all beneficiaries and members. There is no distinction made between new and existing clients.
• Consent to record must be obtained for all calls.
• Recordings are not required for in-person activities.
• Medicare requires all records be maintained for 10 years”

In English, we are now required to record ALL telephone conversations that have anything to do with Medicare.  There are no exceptions.  For example, if you live in Billings, Montana and call your local agent on October 2^nd to confirm your October 17^th appointment, the conversation will sound like this:

Bob Smith, Insurance Agent – Thanks for calling Smith Insurance.

Larry Jones, longtime client – Hi Bob.  It’s Larry Jones.  I’m just calling to confirm our appointment for Monday, October 17^th at 11 AM.

Bob Smith – Hi Larry.  Before I can go any further, the government requires me to read the following disclosure to you: “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”

Larry Jones – What the Hell does that mean?

Bob Smith – Wait, there’s more.  I need to ask your permission to record this call.

Larry Jones – Why?

Bob Smith – Every Medicare related phone call has to be recorded and kept for ten years.

Larry Jones – You’re kidding!

Bob Smith – I’ve been your agent for over 10 years.  I wish this was a joke. May I have your permission to record this call?

Larry Jones – Fine.  Just do it.

This is going to work as well as the Cone of Silence.

Your local agent is working through this process.  We are researching different recording systems all the while hoping that this rule will be put on hold for a year or two or hopefully twenty. Smart agents already retain copies of all emails and take copious notes during in-person meetings.  Recording phone conversations will complicate our lives and undoubtedly feel like one more intrusion into our client’s privacy, but we will all survive.

As per the disclaimer, HELL YES, WE DON”T REPRESENT JUST ANYONE.  Your local agent is solicited daily by the insurers and marketing organizations.  We each choose which companies we want to represent based on our experience with their service, networks, and product design.  I refuse to represent certain well-known carriers because of issues I’ve had with their service.  Not offering every plan available in the area is not a negative.  Your local agent is proud to represent only the companies he/she selected.

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The doctor is a social acquaintance.  He is not really a friend.  He is not a client.  Doc wanted me to know that we are “just breaking the surface” on COVID.  He used the phrase several times to emphasize how much more there was to know and how little those of us in the general public knew.  As a doctor he was privy to so much more, none of which he planned to share with me, a mere insurance agent.  I’ve known him for a number of years.  This wasn’t the first time I had encountered his demi-god shtick.  Still, I would have been happy to learn any useful information he might have been willing to share.

But I have information, too.  I have a couple of years’ worth of conversations about COVID with my clients.  I know that some of my clients have spent time in the hospital and that, sadly, some have died.  We’ve discussed the lingering effects of long COVID and the question of when/if the individuals will ever fully recover.  And some of my clients have had other non-COVID illnesses that seem to last for months and months.

My clients share their health concerns with me.  We discuss their fears about tests and procedures, the potential costs of hospital stays and the newest drugs.  Another big topic are the doctors who don’t listen to my clients’ concerns and only ask the questions from the pre-printed checklist.  Some of those conversations are with people under age 65 and some are with Medicare beneficiaries.  Most Medicare beneficiaries will refrain from deep, personal conversations once their calls are recorded.  That’s a shame.  Our in-person meetings will just have to be a little longer.

Dave

www.cunixinsurance.com

Picture – Would You Believe A Shoe Phone? – David L Cunix

Sally’s phone was buzzing.  It must be important.  It was a text message at 7:30 on a Saturday morning.  She checked her phone.  It was another message from healthcare.gov.  I asked her how often the marketplace was sending a 66 year old woman a text to purchase individual health insurance.  Her answer was, “almost daily”.  I was shocked.  She was amused.  With healthcare.gov you are forever young.

The pendulum has swung to the other extreme.  The individual health insurance market survived four years of sabotage.  Now we have an administration so eager to have everyone covered that Pete Buttigieg might personally drive you to my office.  We have good, positive advertisements on radio and television.  We had an extra Open Enrollment Period this spring and summer. The marketplace worked really well this year.  And consumers who have purchased policies through healthcare.gov have received lots and lots and lots of reminders to visit the site to renew their plans.

But do you need to visit healthcare.gov to renew your policy?  NO.  The policies renew automatically.  Check your subsidy.  If you want to keep your current policy and you haven’t had any changes in your income, there really isn’t a reason to go into healthcare.gov.  Confirming your status could be five minutes over the phone with your agent.  If you want to explore your options or adjust your subsidy, yes, visit healthcare.gov either on your own or with your agent.  The policies are the same price with or without an agent, so you might as well find someone you trust to guide you through the process.  But if nothing is going to change, don’t let the daily texts, emails, and calls push you.  If you are fine, you’re fine.

The system does not pick and choose who should reevaluate their plan and who can just let the policy renew.  Healthcare.gov contacts everyone who has had a marketplace policy.  Heck, it even nudges people who have turned 65 and are now on Medicare.  Because healthcare.gov assumes that you don’t know about Open Enrollment and that you are forever young.

DAVE

www.cunixinsurance.com

Picture – A Wild Ride – David L Cunix

Can’t Buy A Thrill

Can Always Spot A Shill

We are about to enter Open Enrollment season.  There are lots of commercials on television hawking plans for those of you under age 65 elbowing their way between the ads from washed up athletes and C List celebrities.  And don’t forget all of the smiling, happy people having fun while the voice-over describes the dangerous side effects of the newest medications.  Now is the time to remember that the focus of our organized health care system isn’t health.  This is a payment system structured to compensate medical providers and, to a slightly lesser degree, help fund political campaigns.  That isn’t a good thing nor necessarily a bad thing.  It just is.

There was a time, not so long ago, when Americans retired from their jobs, said good-bye to their work provided group health policy, and hoped to either have the resources to cover their final medical expenses or to die cheaply and quickly.  A lingering illness could lead to financial devastation.  Bills were introduced in Congress to address this issue.  Opponents claimed that providing for the elderly would inevitably lead us to Socialism.

The most vocal opponent in the late 1950’s early 1960’s was the American Medical Association.  The organization and the doctors it represented were worried that a national program to provide insurance to senior citizens might limit their income potential.  And to a point, they were right.  So in 1961 they hired an actor, one with political aspirations, to record a presentation for the association’s Operation Coffee Cup.  Here is the full recording.  Even with all of the self-deprecating humor and the scary imagery, the American public could spot a paid shill and ignored Ronald Reagan.  It only took four more years.  We got Medicare on July 30, 1965.

We intuitively understand the difference between advocacy and exaggeration.  Many organizations believe that whatever is best for them is also the best for you.  Just ask them.  In 2021 an industry group can always rely on a friendly think tank, the compliant evening talk show host, or, if necessary, a recently formed consumer group to promote their interests.  Throw enough money in the right direction and you can find a group of hogs promoting the benefits of bacon.

That squeal you’re hearing on television is from Big Pharma.  Trudy Lieberman recently wrote for the USC Annenberg Center for Health Journalism:

Pharma and ideologically allied groups are also promoting the message that drug negotiations are bad public policy. Between July and early October, 10 groups opposing such negotiations, including the trade group PhRMA, have will have spent at least $23.7 million mostly in TV advertising to promote its message that drug negotiations are bad for patients. The 60 Plus Association, an organization claiming to represent seniors, ran an ad on broadcast and cable channels “I’m Sorry They Just Said No,” telling viewers Pelosi and Schumer want to cut their benefits. The American Action Network spent about $5 million also on broadcast and cable outlets warning viewers about Pelosi’s “Socialist Drug Takeover Plan.”

The American public isn’t buying it anymore now than they did in 1961.  A recent poll by the Kaiser Family Foundation found that most Americans want the federal government to negotiate drug prices. Even after being presented arguments from both sides on this issue, the results were:

• 95% of Democrats
• 82% of Independents
• 71% of Republicans

favored government involvement.  Whether this means the end of the “noninterference clause”, the passage of one of the bills currently pending in the Senate, or some new legislation has yet to be determined.  What is clear is that the American people, the ones paying for the medications, know that the time has come for action.

You will see a lot of commercials on television and the pharmaceutical industry is shoveling cash to elected officials at a record rate.  And there will be a lot of squealing about Socialism.  Just remember what Ronnie would have said. “There you go again”.

DAVE

www.cunixinsurance.com

Picture – I Can’t Compete With Big Pharma – David L Cunix