Since the Affordable Care Act (ACA) established federally-run exchanges in Missouri, most of the private insurance brokers doing business out of offices in Brookfield and Marceline have either cut back on their sales of health insurance policies or gotten out of the game altogether.
Marceline Allstate Insurance agent Cindy Black-Rodgers, for instance, advises, "I have kept the clients who have been grandfathered in, but I've only written one health insurance policy since Obamacare has been in place. I used to write a lot of health insurance before the Affordable Care Act. I can't provide subsidies, so the health insurance market isn't as attractive as it might be otherwise." And Blake Devoy in Brookfield says, "We've gotten out of the health insurance business since the Affordable Care Act was passed. There are just too many 'hoops' to jump through for too little profit."
One notable exception to the local exodus of private brokers from the health insurance business has been Brookfield-based New York Life agent Jason Weydert. Having specialized in health and life insurance for many years, Weydert explains that when he started picking up clients from other local agents who chose to opt out of the health insurance market, he asked himself a couple of tough questions: "Where are these local consumers going to go for health coverage, and who will some of them turn to when things go wrong with their enrollment in the Marketplace through an ACA navigator or enrollment counselor?" As the primary local private provider of health insurance, Weydert believes that he has a moral responsibility to inform clients of the restrictions and limits imposed by the ACA. He explains, "You, for instance, can't receive a subsidy if you're covered under a spouse's policy.
And if you're given a subsidy when you aren't eligible for it, you'll have to pay it back." Weydert elaborates, "There is no affordability requirement for dependents; affordability only applies to the employee, not to his dependents." He qualifies, "Although there's certainly no intent by Marketplace enrollers to mislead consumers, their lack of understanding about ACA limitations and qualifications for subsidies can cause problems."
Describing how the health insurance landscape has changed since passage of the ACA, Weydert explains, "It's not just about health insurance anymore; now it encompasses income, tax data, other coverages, and eligibility requirements, and financial options. When you focus so much on affordability, you can lose access to care as well as choice of hospitals, doctors and plan designs, especially in the individual market." Weydert points to Anthem individual plans that use a network called Pathway or Pathway X: "This network doesn't cover medical costs at Boone Hospital or some area physicians. The biggest change brought about by the Affordable Care Act is more limited access to services in an effort to control claims and costs. As a private broker, I have to service what I sell."
While acknowledging how consumers with preexisting conditions have benefitted from the ACA, Weydert adds, "The idea behind the ACA is wonderful, but implementing it is problematic; not everyone is equal and their needs aren't all the same; implementation forces me to adopt a one-size-fits-all approach that doesn't account for those differences."
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