NAHU’s Legislative Influence in Context

This blog attempts to addresses health care reform issues of interest not just to brokers, but to a broader audience as well. This post, however, is aimed at brokers only.

Most brokers are disappointed with the Patient Protection and Affordable Care Act. The list of complaints are long, but would include the impact of the medical loss ratio provisions on their livelihood, the failure to deal with rising medical care costs, and a host of issues related to the exchanges.

Brokers fought hard to make health care reform meaningful, to assure it constrained costs and increased access. On some issues we succeeded. On too many we lost.

Brokers are angry with the result and, understandably, are looking to understand the cause. Sometimes its not enough to identify who won. Blame needs to be apportioned. And a surprising number of brokers, albeit a distinct minority, are blaming their own professional association, the National Association of Health Underwriters.

NAHU can defend itself from the specific charges being leveled (and I invite them to do so here on the blog). But if we’re going to spend time on a discussion of what NAHU could and couldn’t accomplished, then let’s have an informed discussion.

For example, I often hear brokers demand that NAHU educate Americans concerning the value of brokers. Ironically, this is a job each and every broker can do simply by doing their jobs in a professional, effective and visible way. But the context that’s missing from this criticism is the enormous cost such an undertaking would involve.

Then there’s the political battles. NAHU is apparently expected to win them all. But here’s a a quick quiz to explain why this might be harder than some believe. In considering your answers, it might be helpful to remember the adage of then-California Assembly Speaker Jesse Unruh that money is the mother’s milk of politics:

Given a political fight, who is more likely to be heard in Congress, Association A spending over $144 million on lobbying or Association B with a total budget – for everything it does – of less than $6 million?

Who is more likely to win a legislative battle, Association B with it’s $6 billion total spending budget or Association C with a mere $22 million lobbying payout?

Would it change your mind if Association B had a Political Action Committee with roughly $300,000 versus Association C’s contribution to federal candidates totaling more than $17 million?

When it comes to influencing Congress, the US Chamber of Commerce is the king of the hill. The Chamber spent over $144 million on lobbying activities in 2009 and another $132 million in 2010. No one else came anywhere close.

With over 225,000 dues-paying members, the American Medical Association is both a grassroots and a financial power. The AMA contributed over $27 million to federal candidates in the 2010 election cycle and spent $22.5 million on lobbying.

NAHU is the one with the $6 million budget (which also covers member educational activities and the like) and the PAC contributions totaling in the low hundreds-of-thousands-of-dollars.

Some other interesting numbers:

The Service Employees International Union spent over $1.7 million on campaign contributions in the 2010 campaign cycle, down from over $2.8 million for the 2008 election.

In the 2008 election cycle alone, the pharmaceutical industry contributed over $26 million to federal candidates.

Of the top spending lobbying efforts in 2009 according to OpenSecrets.org:

  • #1, as noted, was the Chamber of Commerce at $144.5 million
  • #4 was the Pharmaceutical Research and Manufacturers of America at $26.1 million
  • #5 was Pfizer Inc. at $25.8 million
  • $6 was the Blue Cross Blue Shield Association at $23.6 million
  • #7 was AARP at $21 million
  • #9 was the AMA at $20.7 million
  • #12 was the American Hospital Association at $18.3 million.

You get the idea.

The ability of these organizations to devote these resources to advocating for their members is because those members provide them the resources to do so. What resources NAHU has comes from the same source.

NAHU will never be in the league of $20 million lobbyists. Nor does it need to be. NAHU’s influence is far greater than its lobbying expenditures or the size of its PAC would suggest. It may not have the tens-of-millions of dollars necessary to run a national public education campaign, but it has educated lawmakers and regulators about the role of brokers. We did not win the fight on the medical loss ratio, but that battle continues and the loss would have been harsher, but for NAHU.

There are probably more than 100,000 brokers in this country who earn significant revenue from the sale and service of health insurance. Fewer than 25,000 are members of NAHU. That is a travesty, especially since many of the organization’s most vocal critics are numbered among those contributing nothing to the effort. Standing on the sidelines and criticizing is easy, often unhelpful, but easy.

So here’s the context: NAHU’s size is small relative to many of the other players. And here’s the reality: NAHU’s influence is much larger than its size. NAHU’s done much with relatively little. It could do more with more – more members, more revenue, more PAC contributions.

Asking tough questions of the association’s leadership is appropriate and helpful. If your not a member, letting the organization know why, in a professional manner, can be very helpful feedback. Seeking changes to its direction is the right of any member – non-members deserve and get no voice in determining the organization’s future.

So I am not suggesting in any way that criticism of NAHU is wrong. But to be constructive, the complaints need to understand the scale and scope of the political context in which NAHU operates.

20 thoughts on “NAHU’s Legislative Influence in Context

  1. Alan

    You stated that this post is aimed at Brokers and while the post is about NAHU, the fact about follow the money can be universally applied.

    JimK

  2. I hope my response is worded gracefully. NAHU is brave and forceful. They have fought hard and strong. They certainly represent our industry, specifically the HEALTH insurance niche. I can’t criticize anything about it – not their education, nor legislative battles, nor their PR. I just don’t feel like a “member” even if I pay my dues to be a member.

    Boy would I love to join an association of colleagues who band together to educate, support and fight for each other. I was missing that. It’s partly what keeps me coming back to this blog and some other networks of agents. We need each other. The NAHU is clearly the only real association for HEALTH insurance agents. The Big I (Independent Insurance Agents and Brokers of America) is the big association for INDEPENDENT agents, but it’s concentrated on P&C. There just isn’t a big, influential association for INDEPENDENT HEALTH agent/brokers.

    I used to be a member of NAHU, but I couldn’t bring myself to rejoin. Why? Like Al Canton’s comment below, I felt like our local chapter was “bought and paid for” by the large carriers. Every meeting I went to was overwhelmingly attended by carrier reps & execs. Every board, every committee, every influential position went to carriers. Yes, they are agents, too. But when push came to shove, the carriers came up with the prize. Alan mentioned that money talks, and it talks inside an association also. When carriers pay the dues for their employees, reps & execs, it influences. At meetings, I was repeatedly disappointed that the topics and discussions were about our industry, but clearly not about issues independent brokers face. I just felt like an outsider in an association created for my own profession.

    I feel even less represented by NAHU now. The MLR, commission cuts, exchanges… These are clearly issues where the best interest of the carrier is opposite the best interest of the broker/agent. Why should carriers care if agents participate in exchanges, or sell products where subsidy money is involved, or get competitive commissions? Alan mentioned AARP was a large lobby – they are connected with United Health Care and Aetna in direct sales. Blue Cross is a large lobby – again a carrier. In fact, I’m a member of the Chamber of Commerce and I feel more connected with their issues than with NAHU’s.

    I feel so torn. Until now, I’ve kept quiet about not being a current member, out of shame. Guilt. NAHU is a fine organization, working hard for our industry as a whole. I just feel that the influence from the CARRIER portion of our industry speaks louder than the influence from the BROKER side. I haven’t been able to bring myself to rejoin.

    In Alan’s list of lobbies, he also mentioned the AMA and the American Hospital Association. Imagine if one association covered both private practice doctors and the large corporate hospitals. Although tied together in the medical field, there is a clear conflict of interest on many topics. Perhaps we need a separate association just for the brokers. Or perhaps if there were a niche inside the association, just for the brokers, it would help us unify to have one voice. It could make the association pay closer attention to the issues where the brokers’ voice is heard as equally as the carriers’ voice. Perhaps more brokers would join. Alan mentioned that only 25,000 out of an estimated 100,000 health insurance brokers are members. Perhaps many of them feel the way I, Al, and Curt have expressed, and may join if we felt represented. It’s kind of like “no taxation without representation”. I feel like I’m paying dues, but not really a member.

    I’m afraid, however, that a downward cycle has begun when it comes to agent/broker membership. The brokerage community is bound to decrease as agents exit the business. The remaining brokers’ reduced commission leaves less in the budget for dues. Carriers, however, still feel a strong need to unite as a force to influence the modification of PPACA. Carriers will still pay the dues for their reps & execs – more money, more influence. I feel that if NAHU wants to court the agent/broker community, they need to tell us now what value they offer to us, specifically as our issues are conflicting with the issues of the carriers.

    • Ann,

      I think that your post is indeed “gracefully” stated.

      I am a current member of NAHU and have been since 1978. I have also been a deeply involved, actively involved member, since 1984.

      Many of us have been questioning NAHU’s “reason d’être” since the issue of discussing commissions and naming companies came up on a LinkedIn NAHU discussion site. While I understand the sensitivities of NAHU being a Non-profit 501(C)(6) corp., and that we can never engage in what could be considered to be price-fixing and a couple of other not-for- profit issues, it can be difficult when the NAHU Staff seem to be less than concerned about the plight of the very people whose money supports NAHU (ostensibly the Agent/Broker Community) than disturbing the status quo in NAHU’s funding received from the companies, the carriers.

      I have heard from some who are attending Capitol Conference that they’ve heard not just a few comments about “Membership falloff”, but many. It will doubtfully not improve as more and more in our community (agent, not company) suffer from the fallout from the PPACA, and will instead, worsen. Personally, though I will always remain loyal to NAHU, I think that an “arrogance” has developed in the NAHU Staff, instead of the staff being constantly aware that the Agents created NAHU, and if they perceive that NAHU is not “there” for them when the going gets particularly tough, NAHU will begin to experience serious problems. Many of those staff may lose their positions.

      When HillaryCare was adopted by the Washington State governor and legislature in 1993, I was giving many “talks” to WAHU/NAHU chapters, and saw many eyelids close. Feeling that I was wasting my time (donated and volunteer, or course) one day I stopped in the middle of a sentence and asked in a very loud voice, “How many in this audience are agents?” Maybe a third of the hands went up. Then I asked, “How many of you are company people (HMOs, HCSCs, Commercial)”, and all the rest of the hands went up. I then asked, rhetorically, “If the Agents cannot continue to write business and send it to the companies, how long do you think it will be before the companies feel the pain and lay you off, fire you?” Amazing, no one nodded off the rest of that day, and from then on I began my talks (those that focused on HillaryCare) with a reminder to all that their jobs were no less subject to being eliminated an ours, if the new HillaryCare was not seriously amended, which it was in 1995 with the “Health Care Improvement Act of 1995”. I was much honored when I was asked to write a small portion of that Act.

      There are several “groups” that are attempting to address these issues. Any who wish to inquire about these efforts may email me at spencerlehmann101@msn.com.

      Alan’s blog (without doubt) is one of the very few that allows those posting here to express their frustrations and fears about their futures. None do it as well, with excellent commentary as written by Alan, as his.

    • Ann – perhaps what would have made a great Alan post was a unity cry for the Agent Community equivalent of the “Tea Party” and march on Washington or statehouse. Perhaps putting ourselves in front of the media as a group of LICENSED professionals who are about to be wiped off the face of the earth might resonate with someone somewhere?

      As for me: IF the NAHU is our best hope, it’s time to exit stage left.

    • Ann: Thank you for your response. You did a great job of expressing your concerns — concerns that are shared by many brokers. I think the core of the problem is that people are confusing a professional association with a union. NAHU, like the AMA, is an educational and lobbying organization. Their purpose is to make the public and decision makers aware of their members’ perspectives and value and to lobby lawmakers and regulators on behalf of their members. That’s what NAHU, and the AMA, does. Neither gets involved in negotiating compensation on behalf of their members with specific organizations. To do so would jeopardize their tax standing.

      The AMA doesn’t negotiate contracts on behalf of their members contracts with Kaiser or HCA or any other private enterprise. And NAHU doesn’t negotiate contracts on behalf of its members with Kaiser or Aetna or any other carrier. The AMA will lobby Congress or HHS concerning how Medicare reimbursements are calculated and other laws and regulations which impact their members’ pocketbooks. And so does NAHU. Again, this isn’t because the AMA membership includes hospital administrators and employees. Nor is this because the NAHU membership includes carrier employees. The reason for both organizations is the same: they are professional associations subject to IRS codes that prohibit union-like activities.

      If brokers want to organize to negotiate compensation with carriers they can do so — all they have to do is form or affiliate with a union. There are lawyers representing doctors, lawyers, nurses, engineers and other professionals. Brokers can, I suppose, do the same. But that union would not be NAHU anymore than SEIU is the same as the AMA.

      And Curt, hundreds of brokers have organized and marched on Washington. They are there today, in fact, meeting with lawmakers and their staff, educating them about the role brokers play, of the need to amend the PPACA (and many are no doubt urging its repeal). NAHU has organized this march. They act professionally. They both listen and speak respectfully. These brokers remind their representatives that their clients are the Members’ constituents, but they don’t threaten. This may not be Tea Party enough for you, but they are probably more effective as a result. (It should be noted that a significant number of these brokers are probably members of the Tea Party).

      The vast majority of these brokers are just as angry as you and others who have commented on this blog. They feel just as insulted and betrayed by their representatives. They are just as busy contemplating changes to their businesses. Yet they’re not sitting around complaining about it, they are doing something about it. And they have not given up. These brokers are giving of their time and money to try to make a difference. They may succeed; they may fail, but they refuse to sit on the sidelines. They are engaged and involved and if change comes about it will be in large part because of the actions they are taking today and throughout the year. Those who simply complain will benefit from whatever success they achieve. Those who talk, but fail to act, will gain from the sacrifices these activists are making.

      Again, I believe NAHU is our best chance to make changes to the PPACA that will benefit brokers and our clients. NAHU is an exceptional professional association. If it is far from perfect it is because it is made up of humans and we, as a species, are far from perfect. Its decisions are made by the dues paying membership — taxation coupled with representation in the truest sense of the word.

      Brokers who read this blog should make their own decision as to whether supporting NAHU or not is worthy of their time or dues. But at the very least they should thank those who are willing to take action to achieve change rather than condemn them for trying.

      • Alan, of all of the many and varied explanations I’ve received from other NAHU members and Past Presidents like yourself, none have been as clearly stated as this: “The reason for both organizations is the same: they are professional associations subject to IRS codes that prohibit union-like activities.”

        Thank you.

        Spence

      • Alan: What a well written response. I believe your explanation of why the NAHU cannot negotiate compensation is valid, and clearly stated. This answers the criticism posed recently on Linked-In, although that criticism is not one that I personally hold. The person who voiced that criticism was pointing to one particular incident where he felt the NAHU let down the agent/broker in preference to the carriers. His particular point was invalidated because of non-profit rules, but I believe we lost sight of the broad complaint because the particular criticism was invalid.

        I believe agent/brokers are concerned about whether the association would “go to bat” for us when the best interest of the broker/agent is in conflict with the best interest of the carriers. This includes issues such as commissions squeezed by MLR rules or challenged by the exchanges.

        Anyhow, since the NAHU is really the only voice for the agent/broker, and it remains an organization that reaches levels of excellence in all they do, it deserves my support. I do feel that the agent/brokers need a unified voice (either inside the NAHU or outside), but that unified voice can exist in concert with the NAHU, not in conflict with it. The NAHU is an organization of excellence. I do wish they would reach out to the agent/broker community and express their value to our segment in particular. If they clearly expressed their intentions to fight for our involvement in the exchanges, and our need to be fairly compensated for our services, I think this marketing outreach would raise more funds than raising dues would accomplish.

        Whether they do this or not, they remain a valuable association for our industry. They deserve my commitment. You’ve convinced me.

      • Alan, since I think you kind of went above and beyond in calling me out in your response to Ann please allow me the same opportunity (Before you shut down the thread as I’ve seen you do when things get just this side of negative.). You don’t know me – you have no idea what I have been doing to keep this issue in front of my elected officials and by extension my state legislative body (Which is where the REAL action is because this issue has already left the “DC Station” and arrived at every agent’s statehouse.) but your comments seem to infer that anyone acting within the NAHU ‘body’ is somehow elevated to a higher level of discourse or status by dint of their NAHU membership is both off base and offensive.

        What I say here on this board is straight from the heart – it is not wrapped with a pretty bow and delivered to your eyes and your readers eyes with bowed head and the reverence of a sycophant scraping about for your approval. If that is too much for your blog drop me a line and permanently dis-invite me to your blog. As an industry consultant I imagine it behooves you to stay on the good side of every single industry-type you encounter – I don’t have to labor under that kind of limitation. The only good side I’m trying to stay on is earning a living.

        You know Alan it’s fine for you to make the comments you do but try walking a mile in my shoes and looking at the commission statement I did last night and let me know how delicate you would be in phrasing your disgust after looking at what I did. I’m still on the phone working with clients the SAME amount of time – STILL HELPING THEM WITH THE SAME ISSUES TO A SATISFACTORY CONCLUSION only for half the money. STILL biting my tongue when someone asks me monumentally stupid questions due to the misinformation campaign of the politicians and PPACA – to wit: “Isn’t my premium determined by my income?” MY income has been halved but the work flow continues apace. Given up Alan? Hardly – I just keep working my *** off for half the money.

        Have your consulting fees been slashed? In half? Are you working the same amount of hours – EVERY WEEKEND INCLUDED – for half the income?

        You’re damn right I’m annoyed and you’re damn right I am actively working on an exit strategy. Despite your continued refusal to see the Exchanges for what they are: The death knell of my profession – I will not be lulled into any false hope that 2014 will not be a hell storm for health agents. If my realistic approach to this situation offends you, then boot me – I’ve been kicked out of better joints.

        • One other comment: I can not tell you how many phone calls I have taken from parents looking for child only health plans. Thanks to decisions made by the health insurance companies this is all a manual process now. I have spent countless hours on the phone MANUALLY quoting premiums to a parent or guardian and explaining in great detail the subtle differences between a range of plans. Sending them an application. Only to get…..bupkis – these folks simply aren’t buying the plans and seem especially unwilling to sit down to a paper app to get what they came for.

          I am left with a few observations:

          PPACA has already adversely affected the speed and efficiency with which I can do my job and earn a living.

          The insurance companies have been very savvy and effective in setting forth just high enough barriers to weed out the lazy and casual insurance consumer to avoid a market segment they appear to want no part of.

          Folks who are going to buy a plan are going to buy a plan. You can not levy a small fine on these folks and expect that it will impact their buying behavior when it comes to health insurance. No way no how.

          I’m still waiting for how any of the PPACA legislation has positively impacted the lives of consumers who wanted affordable health coverage. Not seeing it now and KNOW beyond a shadow of a doubt I won’t see it in the future.

        • Curt: My apologies. I can see how you took my earlier comment the way you did. My point was not that lobbying Congress and state lawmakers through Health Underwriters was the only way to influence what happens, but to point out that they are lobbying — not in a Tea Party-type way, but in a manner I personally believe is more effective. (Reasonable people will and do disagree on that last point). What I didn’t mean to imply is that you, specifically, are sitting around complaining instead of doing something more constructive, but in re-reading the comment I see how you could have taken it that way. Again, my apologies.

          Nor do I criticize you for having an exit strategy. Only you know what’s the right approach for you. Every agency in which individual sales and service is a significant revenue driver is going to have to change — and that change won’t be easy or painless. Leaving the field is one option. Diversifying is another. And there are other alternatives. Where I think you and I disagree is that you believe the die is cast and it only gets worse from here. That’s not how I see it, but I respect your viewpoint. It needs to be heard and you express it well and sincerely.

        • Alan – my apologies too. I’m just one angry guy these days and that commission statement didn’t help. I think my perspective on this is tainted by virtue of the fact that I do this every day: I speak to people who are just not going to buy health insurance (Never mind themselves – they just aren’t going to buy a plan for their kids and that really drives me up a wall.) I just sit here each evening and try to steal myself to spend the next 45 minutes on the phone with a “client” for a grand total of $9/mo – knowing that my close rate is approaching abysmal with the old fashioned paper app and a fax machine approach.

          After every one of these I just sit here and ask myself: How is a fine of a few bucks going to influence consumer behavior and the answer is all too clear. It’s not. We are pushing this whole subject matter towards a cliff and the folks doing the pushing are convinced they know something that we here in the trenches don’t. I’d be willing to bet that the guys fighting in every trench in every war knew long before the generals that their war was lost. I think this all boils down to my perception of one thing: NO ONE is listening to people like Ann who could actually infuse the discussion with a very necessary blast of reality and perhaps avert that oncoming cliff. I won’t include myself in Ann’s league though. You’re right about one thing when it comes to me Alan – I have no more patience or diplomacy left in me when it comes to this truly idiotic situation we find ourselves in. I think if I heard just one Democrat admit that there might – MIGHT! – be some issues worth fixing with PPACA I’d feel a burst of optimism. Failing that the best course here is ‘hope for the best – expect (and prepare) for the worst’ (And when it comes to Washington and Sacramento expecting – and GETTING – the worst has become a pretty safe bet.)

        • Ann, Alan, and Curt:

          I’ve just read and reread your posts and I am so impressed. Each of you presented a bit of a different perspective, and you did so with meaning, articulation, and guts.

          I’ve been active posting on blogs for a few years, but I rarely have read such heartfelt, gut-wrenching honest posts as you’ve presented.

          Ann and Curt, I’ve spoken this past couple of days with friends and colleagues who attended Capitol Conference this week. Just listening to the reports about all of the meetings that took place on “The Hill” has me so charged up that I’ve decided that “With the good Lord willin’ and the creek don’t rise”, next year I will attend as well. Alan did attend and I expect will be writing a commentary about this year’s experience (yes, Alan?).

          Listening and reading the thoughts shared with me gave me a fresh shot of adrenaline about my feelings for NAHU, an association to which I’ve donated much of my emotion and work over the past 27 years (joined in 1978, became really active in 1984). NAHU is an agent driven association, as I’ve often said, and Cap Conference is one of the best examples I know of agents doing their best as a group to change the future for the better for all agents/brokers throughout the country (whether they are dues paying members or not…and if someone is benefiting from the work of their colleagues and peers, then they should be paying their fair share).

          We can, and should be looking for ways that we can help direct the companies, and the insurance consuming public to recognize the value and worth of those of us in the agent/broker community, and to give ourselves a far greater voice in the manner in which we are compensated for our time, educational knowledge, and efforts to educate and help design health insurance plans for the public, but that doesn’t mean that we can’t appreciate the role and hard work that NAHU brings “to the table”.

          Sometimes, by questioning with passion expressed fiercely, we can discover some really good answers.

  3. Alan,

    As one who has access to several insurance commissioners who rank very highly in the N.A.I.C. I was told point blank by them that they recommended to HHS (with not-for-profit carrier approval at least and NAHU support) that broker commissions up to 5% of premiums be exempt from overhead for the carriers. If you read the PPACA (and I have) it specifically mentions broker premiums as administrative expense, so the NAIC felt that they couldn’t recommend “officially” that commissions be exempt. They did insist that HHS give them another shot at the formula in a few months, and I have it on good authority that the 5% waiver will be part of a more detailed proposal yet again, this time with legislative support especially in the House.

    What I can’t abide by is the way some carriers have used this debate as a smoke screen to cut commissions even when their finances don’t require it. I suspect this is mostly a for-profit problem (rocket scientists on the weekly WS Conference call insisting upon it to bolster share prices) but it is wrong either way.

    Anyway, the Commissioners I have spoken to said NAHU and many of their state representatives provided critical information in the formation of the “exemption” calculation and they don’t think it’s a dead issue yet. They confirmed to me that NAHU is having an affect in the regulatory phase of this aberration we call PPACA, but in the Legislative phase, no one in Congress was listening to anybody in the industry period. Everybody in healthcare got hammered even docs, hospitals (you should see the new Medicare payment penalties), drug companies, device manufacturers, carriers, everyone.

    Time will tell. Hang in!….WR29

  4. Alan, it’s great that people of different opinions are free to voice themselves on your blog. This post is certainly no exception!

    I strongly believes that NAHU supports the agent 100%. As a result of active participation in CAHU over 10 years, I have kept up on legislative and insurance trends. I’ve developed strategic relationships with fellow agents, as well as GA and carrier reps through networking. It’s paid off in the pocketbook!

    Ten years ago, I barely knew anyone in the Orange County chapter. Frankly, I went to the first meeting because I was writing a PPT presentation on insurance trends, and I needed help. People reached out to me, and the collaborative result greatly exceeded any PPT I could have produced on my own. I gave the PPT presentation dozens of times, and my income grew by 25% in six months.

    At that point, I realized the value of NAHU, and did some soul searching to match my talents with where I could best be of service. I found Legislation to be my passion. The support of fellow agents, and practice, helped me gain confidence and proficiency in speaking to state and federal officials. Unless we keep joining together to tell our story–that agents are an intrinsic component of America’s health care equation–we are doomed. Yes, many of you reading this post may think the ink is already dry on your death certificate. But, to the rest of us who don’t want to give up without a fight–please support NAHU, and urge fellow agents to join, too!

    A quick example of how NAHU reaches out effectively to independent agents: last spring I talked to Janet Trautwein after she spoke at a CAHU meeting. I told her I needed help developing a PPT presentation on tax subsidies for nonprofit businesses. The next day, I received a phone call from Pete Stein (NAHU’s VP of Congressional Affairs). Pete helped me develop a PPT presentation that I presented to leadership of a nonprofit association. Thanks to NAHU’s expertise, the association posted my contact information in their newsletter, and on their website, as “an insurance professional to contact with any questions on Health Care Reform”. Once again, my insurance business has grown as a direct result of help from NAHU. The increased commissions far exceed my annual NAHU dues, and surpas the extra I gladly give towards CAHU and NAHU PAC’s.

    How can YOU help us expand agents’ territory in the HCR arena? I strongly endorse membership and participation in NAHU as your cloak of visibility! But I’m just crazy enough to think Americans will need agents more than ever to explain and implement this crazy thing called PPACA!

  5. I was a member of the Sacramento chapter of NAHU a few years ago. I found that it was basically “bought and paid for” by the large carriers.

    Any time there was a “conflict” between carriers and agents, NAHU always sided with the carriers. Case in point was when one large carrier about 3 years ago cut comp to Calif. agents… not a peep out of NAHU on it. I brought up the issue and Bruce B. (some will know whom I’m talking about) told me it wasn’t something that NAHU “had time” for or wanted to bother with.

    I’ve always believed that Janet T. spoke much more on behalf of the carriers than she did for agents. And I’ve always believed that if it came down to agent comp, vs. carriers going out of business (i.e. single-payor) that NAHU would quickly line up with the carriers and throw us under the bus. (And one could make an argument (as some have done) that this is what really happened in the “smoke filled” backroom discussions on MLR.)

    You can’t have loyalty to two masters and I don’t think NAHU understood the basic fact that carriers have a different agenda than agents a lot of the time.

    I think if NAHU decided to no longer accept membership of carriers and their staff (and money) and said “Hey you agents, we are here for you and you only…” I could see it. But in my area the top slots in the local chapter are almost always “taken” (given?) by carrier reps or GAs. I never felt that NAHU was looking out ONLY for MY best interest.

    Finally, look at it like a sports team would. NAHU is paid to win. Obviously, they “lost” big-time for their agent members. So where is the value-proposition for agents to keep supporting NAHU? In sports they fire the manager and shake up the team.

    When agents see some changes in how NAHU is run and especially what their prime-directive is… I think some agents will reconsider… assuming there are any agents still left selling health insurance FULL TIME in this business come the end of this year!

    I won’t be one… I’m pretty sure of that. 9% for IFP is simply not sustainable for anyone like me who has a very expensive wife!!

  6. Hmmm.Maybe we need to raise dues 200%. No, that wouldn’t fly. I guess, as you say, one of the best ideas is to further educate our clients and consumers what life would be like without our services…which, incidentally, are free to the consumer.

  7. Well Alan – allow me to kick this one off (On the negative side) by saying that – as things stand now – joining NAHU just isn’t in the cards. If they are having membership ‘issues’ now wait ‘til they see what 2012, 2013, AND 2014 (!!!) bring!
    The smart play here is to cut out every single unnecessary expense and start working on your Plan B. Your post actually strikes me as kind of humorous: You perfectly illustrated why the NAHU is not a viable option for us as we see our President demonize our industry at every turn. Even in the best of times (And this sure ain’t one of them!) the ability of the NAHU to be a “player” would have been a challenge. Now we’ve likely got agents who are – if they’re smart – thinking seriously about a Plan B. That means our ranks are shrinking – not even staying level – but actually shrinking as each day closes and we get closer to 2014.
    Alan, Plan B doesn’t involve spending money on a NAHU membership and hoping against hope that these guys can suddenly leverage their meager budget and political heft (hehehe) into something closely approximating being a real and meaningful voice for our profession in Washington. Even contemplating that is being politically naïve Alan: You know as well I do that the genius behind PPACA is that it has spun itself into a 50 prong attack on our profession as the political battlefield is no longer solely that of Washington but in each Statehouse in each of the 50 states.

    If your post was meant as offering the reasoning that explains why NAHU has been absolutely useless in stemming the legislative onslaught that is PPACA and the ultimately devastating effect on our profession, then kudos; you succeeded. If your post was meant as some sort of rallying cry to drive increased NAHU membership….well…uhh….thanks but no thanks….why not ask me if I’d like to take up a membership in the AHBS (Association of Horse & Buggy Salespeople)? Same difference.

  8. Very well presented, Alan!

    I am a long time member of NAHU (1978) and Member Activist (1984-current) and will remain so.

    I appreciate the perspective from which you presented your commentary, and think it to be articulate, to the point, and accurate.

    As always, Alan, well done!

    Spence

  9. Thank you Alan! I have broker friend that has left NAHU because she couldn’t see the value, and the dues increase upset her. Since that departure we have had a few discussions. In one conversation I was sharing something I recently learned regarding industry changes. She was unaware of the changes and asked that I send her the article. I took the opportunity to tell if she was a member of NAHU she would have already seen what was in article. I will continue to take every opportunity to point out the value to her.

    Alan I appreciate your blogs and all that you do. I am a former CA agent and grew up in the business with Blue Cross and you behind the helm. I learned a lot from you then and I still am.

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