John McGough, Statehouse Lobbyist for the Ohio Association of Health Underwriters shares a legislative update from the February 8, 2018 CAHU meeting at Hollywood Casino Columbus.
- What is a 1332 Waiver?
- How might 1332 Waivers help address Ohio’s opioid problem?
- What about Ohio Legislation to improve healthcare transparency?
- How can CAHU members support efforts of OAHU?
- How does your work impact CAHU members and their clients?
What is a 1332 Waiver?
McGough: “A 1332 waiver is to really look at the uniqueness of each state and what rules or laws that they may want to change that would help them, with the use of some federal subsidies to potentially improve their individual and small group markets in the state of Ohio and other states. Several have been approved. Ohio, as you know, has recently been looking at a possible waiver. ell, waivers are always looking at how do w e bring more people to the table that they can provide affordable insurance. So reinsurance has been one of the mechanisms to help reduce the costs since they bring the premiums down. You look at things like, sometimes HMO type products, networks where you can have providers agree to better reimbursements, things like that. It’s basically allowing some relief from the current laws to use tools through subsidies and also networks to drive down cost.”
How might 1332 Waivers help address Ohio’s opioid problem?
McGough: “We have a huge opiate problem in the state of Ohio. Ohio is one of the worst in the country when you really get down to it. One of the things we have from a delivery standpoint, Ohio has become a heavy state, as far as delivery of counterfeit drugs and that type of thing. I think in summary on the opiate issue and the 1332 waiver, clearly with Ohio being somewhat ground zero as far as a problem area, I think redirection of a lot of mental health, prescription drug, potential solutions and bringing professionals to work on this problem, get people in the right setting at the right time, I think it could be potentially successful in the state of Ohio.”
What about Ohio Legislation to improve healthcare transparency?
McGough: “There’s a bill—Senator Matt Huffman from Lima, has introduced Senate Bill 227. What it really does is, would allow employers and the health benefit specialists that represent them, receive claims data to really empower the employer to be able to understand what their cost drivers are, and so maybe make some changes to their plan or education of their employees. And also, it allows them to potentially look at what other insurance options are in the marketplace. So we’re very supportive of it. We believe that this can be something that helps employers make better decisions about their health care, and could potentially help reduce costs. The other bill is…we have a doctor representative, Steve Huffman from the Piqua, has been involved with the issue of “surprise” bills, meaning that you don’t fully understand when you receive a procedure, what those costs are, and essentially you are surprised at maybe something’s not covered, it’s out of network, you thought you went to a network hospital but the physician that performed surgery on you was not in the network. This bill really tries to focus, balancing both provider and insurer issues surrounding this issue to really empower the consumer to understand on scheduled services, that they understand whether their health insurance is going to cover the procedure, whether all the providers that are going to be part of that process are in the network, and to be able to make these decisions before they get the procedure, instead of worrying about the problems afterwords.”
How can CAHU members support efforts of OAHU?
McGough: “Actually, the last two bills we talked about are actively being heard in legislative committees at the statehouse. I would encourage you to call your legislator. If you go to Ohio.gov and click on Ohio House, Ohio Senate, it’ll take you right to a listing of all the legislators and where they’re from. You can get their address. You can get their phone number. Frankly, it’s as simply as saying, “I work in this industry. I think these two bills will be helpful to providing consumers better access, better decision making for their health care. So I think that’s a great idea.” Legislators love to hear from people back home and how they’re really impacted by legislation that’s in the process. So I hope OAHU and CAHU members take these types of efforts. They really mean something.”
How does your work impact CAHU members and their clients??
McGough: “Well, there are 99 House members and 33 senators. And so what you really do, is not that you don’t meet all of them, introduce yourself when you have a new legislator come in, one of the things I do is, go introduce myself. I explain to them what clients I represent in the case with the health underwriters. I talk about the nature of my client’s business, and say that I want to be a resource. And I’ve been very happy with how CAHU members and our membership as a whole, have participated in this process. So I kind of view—I view my job as one piece of the pie. You guys are the experts. Our campaign money is helpful to our process. It’s all part of what I call the whole government affairs program.”