HALLOWELL – The Joint Select Committee on Health Care Reform Opportunities and Implementation has held all but one of its five scheduled meetings. I had opportunity to attend several hearings.

The committee has focused heavily on exchanges, the marketplace the state is charged with creating by 2014 under the federal law.

It’s important to understand that professional licensed insurance agents serve as the exchange in today’s market. Consumers and employers utilize agents to compare insurance options, seek advice, and ultimately purchase health insurance. That holds even truer for businesses.

They have to comply with multiple laws and regulations, such as Section 125 rules when employees pay a portion of premiums via payroll deductions, Section 105 rules impacting employers’ ability to vary contributions among employees, participation requirements, state and federal regulations, etc.

Professional agents help employers navigate these complex issues while shouldering additional responsibility to support employers in educating employees, manage billing, personnel changes, and so on.

I was not surprised to hear testimony that the Massachusetts Connector exchange has served very few companies, as they tend to continue relying on their agents and are purchasing outside that exchange. Their needs extend well beyond their insurance purchase.

It is also important to remember what is at the root of this discussion, the health care we as individuals want or need and how to pay for it, a challenge unto itself.

The Joint Select Committee is charged with reshaping the health insurance industry. There is one final meeting left before recommendations will be made and legislation developed. How could they possibly develop a deep enough understanding of this industry in that amount of time?

With all due respect to the committee and Legislature in saying that, I’ve worked in this industry for almost 12 years. The time I’ve personally invested to try to understand the new health care reform law and its implications measures in the hundreds of hours.

I will invest hundreds more and never fully reach the end, and that is starting with a solid frame of reference. This is a complex industry because health and health care take many forms, financing health care with insurance results in very complex contracts, and the rules and regulations impacting health insurance and employers in general are both complicated and ever-changing.

Working in this industry as a broker and consultant requires constant attention, education and personal development. So, I ask again, how could the Legislature possibly develop a deep enough understanding of this industry in that amount of time?

It makes you realize how important the people who testify are. They provide the Legislature with the information they need to make competent decisions.

I watched several people testify. Two consumed the majority of the time one afternoon, and both were policy experts with little or no practical experience. Again, I mean no disrespect, but their testimony was by default extremely high-level and conceptual.

For example, one included a bullet on a presentation slide referencing the fact that the Legislature will need to decide whether to merge the individual and small-group markets.

Actuarial studies have been developed to study that question, as the implications could be immense. The most significant potential impact is higher rates for small businesses, a decision that clearly should not be taken lightly. You could spend weeks digging into that one question alone.

I’ve also heard a number of interest groups testify. One consumer group stated that insurers and health care providers should not participate in the governing board of the exchange to avoid conflicts of interest.

Let me get this straight, the insurers will pay for our care delivered by the providers, all with our money, yet both will be absent from the discussions about how much money is needed and what specifically it should pay for?

Won’t consumers be best served if all of the stakeholders are at the table, especially those with the most knowledge and experience delivering and financing the health care we consume?

Now we add to the mix a new administration and Republican majorities in the Maine House and Senate. How will this changing of the guard affect health care reform in Maine?

We have to keep a close watch on this process. We are talking about our health care. Getting this right couldn’t be more important.

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