During a House Education and Workforce Committee hearing prior to the congressional recess, Rep. Virginia Foxx (R-NC) questioned Marcie Strouse, Partner at Capitol Benefits Group on behalf of the National Federation of Independent Business, about increasing price transparency in accessing healthcare coverage.
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00:00Chairman, Ms. Strauss, we often talk of ERISA preemption as being important for large employers
00:09to avoid the complexity of dealing with the patchwork of different insurance regulations
00:14across state lines. Why is ERISA preemption also important for small employers?
00:21Yeah, that's a great question. Again, it comes down to being treated equally. So small employers
00:26are already at a disadvantage. So offering them plans that are regulated by ERISA, like
00:32the self-funded plans, those are just crucial. It's just another option, another opportunity
00:37for them, again, to be innovative. So we don't want regulations to get in the way when something's
00:44working, which ERISA has worked for a long time. Thank you very much. Ms. Strauss, last Congress,
00:51the House passed the lower cost, more transparency act, which among other things would have required
00:58hospitals and insurance companies to publicly list the prices they charge patients. How would
01:05additional price transparency allow agents in the benefits industry like you to better assist
01:12employers and employees as they make health care coverage decisions? Transparency is vital. I think
01:20we all can agree on that. And right now the health care system has gotten so complicated that it makes
01:27it very hard for people to actually be able to manage their health care journey. And so PBMs continue to get
01:34brought up. And I will tell you, it's not only PBMs in the pharmacy space, there's quite a few stakeholders
01:41that actually impact pharmacy costs. So we need to make sure that we're not only targeting one situation
01:48and asking for them to be transparent. We need transparency across the board. So when we look
01:53at things like site neutral payments, you know, those are the things that we're looking at in that
01:57space as far as the hospitals and all of the consolidation that's happened in the rural
02:02communities across the country. You know, it's intriguing to me that there is this battle not to have
02:10transparency, price transparency. Obviously, we must be on to something if the people who should be giving
02:21us transparency are not giving us transparency, because it's the right thing to do. Ms. Shields,
02:28as you mentioned in your testimony, you were responsible for setting up the Association Health Plan for the
02:34Realtors. Can you discuss in more detail the participation in the AHP you set up? And how did
02:41this participation compare to the participation in ACA plans? Thank you for that question.
02:51Our members were participating in the ACA. We had many that were not insured at all. And then we had many
02:59members that were getting their insurance from their spouses, if that person happened to be working. And
03:05of course, we did have some on Medicare or Medicaid. When we offered the plan, we had done many, many
03:13surveys. And this is something that was a benefit that our members had asked us to offer to them. So
03:19when we set up the plan, we didn't find that it took away necessarily from the ACA. What we found is
03:27it was a choice that our members were able to look at to see if it was a benefit for them and their
03:33family. And so we did have a lot that came to our program, because they found that it was either saving
03:40them money, it was a better deductible rate for them, or they were able to have a pre-existing condition
03:46that was covered, or they were able to keep their doctors or for any other number of reasons. The problem
03:52that we found back to Mr. Scott's point with the ACA was that the ones that were in there with a
04:00realtor, we were talking earlier about people that are unemployed. Well, if you know a realtor,
04:05they're going to tell you they're unemployed every day. They have to get up every day and go find their
04:09work. And with that, you might have an average price or an average income that they make, but it's not
04:16necessarily something they're going to keep year after year after year. They don't get raises like an
04:21employee does. So what happens is that their income is fluctuated. The subsidies, we were being told,
04:30is that they would take a subsidy maybe and then end up having to pay it back at the end of the year.
04:34So they don't necessarily always qualify for those subsidies. So the cost of the ACA did not always
04:43fit them with the lower cost. Well, thank you very much. I think you've done a great job of describing
04:51that situation with realtors from ones I've talked to. Mr. Chairman, I have a question for Mr. Coleman
04:57that I'll enter into the record. Thank you.
05:01Mr.ocado.
05:13You