Insurance Brokers Key To Kentucky's Obamacare Success
ROBERT SIEGEL, HOST:
When the Affordable Care Act became law, health insurance brokers were afraid that they'd be out of a job. The marketplace is online, and the federal government hired navigators to help people sign up. Well, it turns out the expertise brokers can offer is still valuable. And in some of the states that signed up the most people, they have been key. Reporter Jenny Gold brings us this story from Kentucky.
JENNY GOLD, BYLINE: David Combs has been a health insurance broker in London, Kentucky, for more than 15 years. When he first read the health law, he panicked and sold his agency. But then he began to see things differently.
DAVID COMBS: I knew there was going to be a massive change in our industry, and anytime you have massive change in the industry there's opportunity.
GOLD: So he started a new agency. He's sipping an iced tea at the counter of Frisch's Big Boy, a bustling diner off the highway. It's the kind of small business he's always sold insurance to. The policy he could offer to Frisch's before the health law was only available to full-time workers, and it was expensive.
COMBS: Once healthcare reform got passed and subsidies were in place, it didn't make any sense for them to continue to offer health insurance. It was actually a detriment to the employees.
GOLD: That's because under the health law most of Frisch's employees would actually qualify for subsidies to help them buy health coverage on the state's exchange, but only if the business didn't offer them a plan. And that meant a lot of workers at small businesses would actually be better off if the company dropped their coverage so their workers could buy on the exchange instead.
MARY GRAY: My name is Mary Gray, and I'm a server here at Frisch's.
GOLD: Gray's been working here for 10 years. She whizzes around the restaurant with her ponytail bobbing, filling coffee cups and dropping off enormous burgers. Gray was one of only 12 of the 60 workers at Frisch's who bought the company's old insurance policy, but a few months ago Combs came in to help Gray and her coworkers sign up on the exchange instead.
GRAY: I sat down with him, and he signed me up for it. (Laughter).
GOLD: Are you happy with it?
GRAY: Oh yeah - sure. (Laughter). I'm going out of pocket right now, so - just had my deductible which I had that before with the other insurance, so.
GOLD: Gray's plan is also free for the restaurant. Herman Hatfield is part owner of Frisch's.
HERMAN HATFIELD: I thought to some degree it was too good to be true, you know, for a lot of people, what they were paying and stuff like that. But it worked out to where a lot of people got better coverage for less money.
GOLD: It also worked out well for Combs. The key to his success is signing up as many people in small businesses as he can at once. He was able to enroll everyone at Frisch's in just two days.
COMBS: We're running into an industry. A lot of our fellow brokers are running out 'cause they're trying to do it on a onsie-onsie basis. And you'll go broke.
GOLD: About 28 of the workers here qualified for a private plan on the exchange for little or no cost because they don't earn much money. Combs gets a commission of $20 per month for each person that he enrolls. Most of the other workers qualified for Medicaid. He doesn't get a commission for them, but still, Combs is thrilled.
COMBS: Our growth potential is incredible right now, especially as we move into the fall.
GOLD: He says a successful agent might sign up 14 new small businesses in a year. Since Obamacare went live last year, he's been doing that much in a month. Carrie Banahan is the director of Kentucky's exchange.
CARRIE BANAHAN: We've had a great relationship with the agent community here in Kentucky.
GOLD: She says brokers like David Combs enrolled 44 percent of consumers who bought exchange plans in Kentucky. That's compared to just 8 percent nationwide.
In many states, brokers fought against the health law and against navigators - workers paid by the government to help people sign up for Obamacare. But in Kentucky, Banahan got brokers and navigators talking by putting them on a special committee.
BANAHAN: It was contentious at first, you know? But once they got to know each other - once they built a level of trust, they get along very well.
GOLD: Navigators were mostly busy signing up the poorest people in the state for free Medicaid coverage. The brokers were more concerned with the private exchange coverage where they could earn a commission. David Combs says brokers have to embrace the health law even if they don't like it.
COMBS: The ones that don't want to get into and educate themselves on healthcare reform - I think they are going to become, you know, kind of a dinosaur fairly soon.
GOLD: But those that can evolve have a huge opportunity. By December, Combs expects his new agency to hit $1 million in sales. For NPR News, I'm Jenny Gold.
SIEGEL: And that story was from our partner, Kaiser Health News, a nonprofit news service. Transcript provided by NPR, Copyright NPR.