On June 10, the House Energy and Commerce Health Subcommittee held a hearing entitled “Lowering Health Care Costs for All Americans: Examining Policies Increasing Health Care Transparency.” While NAIFA strongly supports the Committee's goal of greater transparency and lower health care costs for all, the hearing's discussion of so-called "kickbacks" in Medicare Advantage marketing painted the entire agent and broker community with an unfairly broad brush.
The suggestion that agents and brokers, as a class, are motivated by improper inducements rather than their clients’ best interests is both unwarranted and inaccurate. Licensed agents and brokers are among the most heavily regulated professionals in the health insurance marketplace. They are subject to state licensing and continuing education requirements, rigorous annual certification and testing to sell Medicare Advantage and related products, and compensation limits set annually by CMS. The compensation structure for enrollments is not hidden or unregulated. It is established, capped, and disclosed under federal rules.
NAIFA does not defend bad actors. Where misconduct exists, it should be investigated and punished under the robust enforcement tools regulators have at their disposal. However, isolated misconduct by a small number of entities is not a basis for legislation or rhetoric that mischaracterizes the countless agents and brokers who serve their communities with professionalism and integrity.
The growing importance of agents and brokers is reflected in the dramatic expansion of the Medicare Advantage program itself. Medicare Advantage enrollment has more than doubled since 2014. As more seniors choose Medicare Advantage coverage, the need for knowledgeable professionals who can help beneficiaries understand their options, compare plans, and make informed decisions has grown as well. This trend underscores the essential role agents and brokers play in helping Americans navigate an increasingly complex healthcare marketplace.
In a typical market, a beneficiary may choose among dozens of options, each with different premiums, provider networks, formularies, supplemental benefits, and out-of-pocket exposure. Agents and brokers help beneficiaries sort through these choices and evaluate which plans meet their specific needs, providers, and prescriptions. Agents and brokers remain available the entire year, not only during enrollment periods, to help beneficiaries resolve issues, navigate coverage questions, and reassess options as circumstances change. For millions of seniors, particularly those in rural and underserved communities, a trusted local agent is the difference between an informed choice and a potentially costly mistake. This is the reality, one that is much different than a sweeping characterization that agents and brokers are driven by financial considerations or company-provided perks.
NAIFA shares the Committee's commitment to transparency and welcomes the opportunity to work with members on both sides of the aisle on policies that strengthen oversight and root out bad actors, while preserving beneficiaries' access to professional, personalized guidance. We urge the Committee to engage directly with the agent and broker community as it considers legislation affecting Medicare Advantage marketing and compensation.