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Mike Smith By Mike Smith • November 3, 2016

The Affordable Care Act Miasma

Dear Independent Health Insurance Agent,

The last four years of health insurance has been challenging, to say the least.  With the fourth open enrollment period (or OE4 as it is affectionately being called) in full swing, I have to sit back and think about how far we have come in four years, and yet how much further away we are from a real solution to delivering affordable healthcare.  After all, healthcare is what drives the premium cost, right?


The “Affordable” Care Act offers anything but affordable healthcare.  In fact, there is no argument that anything associated with the ACA is more expensive than four years ago.

The result of the ACA may well be one of the most carefully orchestrated achievements known in the entire history of the USA.  The ACA was never intended to be affordable.  The ACA was intended to do exactly what it has done: increase premiums to a point where insurance companies exit the private marketplace and leave the mess behind so that the Government can swoop in and “fix” the problem. 

There, I said it.  The elephant in the room has been acknowledged.

We know all too well what created the problem.  The real question is, how do “We the People” fix it with a private market solution?  We can’t.  That is the problem.  The ACA was “rigged” to fail (doesn’t that sound eerily familiar?).  “We the People” have been force fed a law so bad, with so many consequences – unintended or on purpose? – that premiums have risen to all-time highs, provider network participation is at all-time lows, and we have far fewer health plan options than ever before.  Now “We the Agents” must go out with a fake smile on our face and deliver the worst news to people who trusted us to help them, all the while working 14-18 hour days during OE4.

Do you put lipstick on the pig and try to convince your audience with a healthcare sharing ministry plan, or do you prefer the short term major medical option instead?  Maybe you should talk about forming a new group health insurance plan?  Maybe we advise people join an Indian tribe or some exempt religious organization, or maybe you tell them to go uninsured.

The harsh reality of this miasma is that we will find it more difficult to offer a private market solution to the public problem created.  Could the “Single Payer Option” create the next generation of health insurance products to be marketed?  If you look back at history, this happened to be the discussion in 1964 before Medicare was enacted.  Yet, somehow, a new product was created called “Medicare Supplement”.  And we still sell these plans 50 years later!

Would you have a problem selling Medicare Supplements to 55 year olds?  After all, Hillary has said she will drop the Medicare eligibility age to 55.  Sounds good to me…why wait for the baby boomers to age-in when we can get this demographic 10 years earlier?

I will close with this.  The more difficult things become, the more complicated things become, the more necessary a good Advisor becomes.  Be the Advisor and lead your agency to new growth.

Tomorrow I will conduct a webinar session to give updates on the Affordable Care Act now that we are in the midst of OEP4: Register Here and join us at 10:00 AM CST.