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Final Push for Affordable Care Act

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Susan Morrissey of Morrissey Advisory Services, a Sag Harbor insurance broker, says there is still confusion over the Affordable Care Act.

Susan Morrissey of Morrissey Advisory Services, a Sag Harbor insurance broker, says there is still confusion over the Affordable Care Act.



            By Stephen J. Kotz

It’s pretty much all over but the shoutin’. After more than three and a half years of fiercely partisan political warfare, the federal Affordable Care Act, more commonly known as Obamacare, will be completely phased in this year.

Insurance brokers and state run exchanges, or marketplaces where the uninsured can shop for health care policies, will likely see a continuing brisk business for the next month or so, as the final open enrollment period ends on March 15, with mandatory coverage required to begin by April 1.

“It ruined my hunting season,” said Karl Washwick, drolly, of the rush to buy new policies meeting the requirements of the law this year. The owner of the Washwick Agency, an insurance brokerage in Riverhead, Mr. Washwick said the final push to implement the health care legislation had proved to be a logistical nightmare for everyone from consumers to insurance companies themselves.

“If anyone had asked me I would have said this is a recipe for disaster. It’s insanity to ask everyone in New York State to switch policies on the same day. It’s the same as telling everyone to renew their driver’s license the same day. Can you imagine the lines if they did that?” He said a phased-in implementation would have saved lots of headaches.

Susan Morrissey of Morrissey Advisory Services, a Sag Harbor health insurance brokerage, agreed that there was still a lot of confusion among consumers.

“At times I’ve felt like I’m a social worker,” she said of all the counseling and hand-holding she has had to do with her clients in sorting out their options from among dozens of plans with various prices that are available.

Although plans that went into effect last year and expire later this year remain valid, any new plan that goes into effect this year has to include pediatric dental and vision care as well as mental health benefits, Ms. Morrissey said.

On top of that, Mr. Washwick said, if they were not already, consumers have to be prepared for a new age, in which just about all plans have high deductibles. “Generalizing across companies and policies, it means about a $6,300 out-of-pocket at most for an individual and double that for a family,” he said.

Both Ms. Morrissey and Mr. Washwick said the vast majority of companies they represent, which are typically in the small business market, have continued to offer insurance for their employees.

But if a company does not provide insurance or a consumer is self-employed, they have two basic options: buy an individual plan from a broker or visit the New York State insurance exchange site, nystateofhealth.ny.gov .

“There are two stores to buy insurance from; you can buy from the state store or the Washwick store,” said Mr. Washwick. The first difference is that someone who buys through the state exchange might qualify for a price subsidy if their income falls below $45,000 for an individual or $95,000 for a family.

Although the prospect of a subsidy sounds inviting, Ms. Morrissey said it’s still a case of buyer beware. “A lot of people might not know that although the same insurers are on the exchanges as you can get from a broker, the networks aren’t necessarily as good,” she said. “People buy policies and then have trouble when they find out that they can’t go to their regular doctors.”

She pointed out, for instance, that Stony Brook University Hospital, recently announced that is not accepting any plans sold on the state’s exchange.

“The only reason you’d use the exchange,” she added, “is if you think you are going to get a subsidy.”

Americans who do not buy insurance face a fine of $95 or 1 percent of their income, whichever is greater, an amount many healthy young Americans may be willing to pay to avoid paying monthly premiums, Ms. Morrissey said.

The Affordable Care Act had good intentions, she said of the effort to make sure all Americans have health insurance. But she said, so far, it’s had mixed results and will likely need some serious tweaking. While an individual policy would have cost about $1,000 last year and policies are now available for as low as $590, people will still end up going to the emergency room when they need health care if they have a limited network of doctors to choose from.

“From the eagle view in Washington, D.C., it’s fabulous,” Mr Washwick said of the $6,300 out-of-pocket limit for an individual. “You get cancer and your total cost is one-third the price of buying a Toyota,” he said. But to the average Joe, it’s ‘Why do I have insurance?’”

The dilemma still vexing this country, according to Mr. Washwick, is that Obamacare “is not health care reform, it’s health insurance reform.”

The question “is how do you get people healthier?,” he said. “The overwhelming number of health care claims are lifestyle claims. Supersize me. Marlboro Lights, please. Yeah, I’ll have one for the road.”

Changing Behavior, Changing Healthcare

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web biz Morrissey

According to the Centers for Disease Control (CDC), in the 20th century the leading causes of death in the United States were chronic diseases such as cardiovascular disease, diabetes and cancer, rather than infectious disease. Seven out of every 10 residents in the United States who die each year, die as a result of chronic diseases, which the CDC also notes affects the quality of life of some 90 million residents and accounts for 70 percent of the total national healthcare costs.

While diseases like these are the most common and expensive health care issue we face in the United States, they are also the most preventable, often attributed to unhealthy behavior like smoking, stress or obesity due to lack of exercise or poor nutrition. This is why some of the largest corporations — in particular grocery giant Safeway — started offering incentives to employees willing to get healthier, thus reducing their healthcare costs as a company.

After watching this trend develop during his 24 years at one of the nation’s larger insurance firms, CIGNA Healthcare, Tom Morrissey decided to strike out on his own, starting the Sag Harbor-based Morrissey Advisory Services, which, in addition to being a full-service insurance brokerage, also is focused on improving the health of his clients’ employees through the Healthy Business Group program. Morrissey has teamed up with his wife, Susan Hansen Morrissey and John White in the venture.

The Healthy Business Group, a unique program Morrissey Advisory Services offers its clients, is a group of small to middle market businesses who have banded together in their commitment to improving the health of their employees, understanding this will reduce health care costs over time. Once signed on to The Healthy Business Group, employees fill out a health risk appraisal, which is confidential and will never be seen by the employer or Morrissey by law.

“Some employees are initially hesitant,” admitted Morrissey. “They think they will be discriminated against by their employer if they see it; but it is actually illegal for them to take a single look at it.”

Instead the results of the entire company are tallied by the University of Michigan Health Management Research Center, which informs the employer through Morrissey about the overall health of their workforce, allowing, for example, Morrissey to bring in a weight management coordinator if results show the company has a number of over-weight or obese employees. For joining the weight management program, employees would be offered an incentive from their employer to encourage participation.

Morrissey said his firm is already looking at partnership with local wellness organizations, to get clients a better rate for services like gym memberships or wellness seminars.

So far, according to Hansen Morrissey – the firm’s small business consultant handling accounts for employers with less than 20 employees – the local response has been positive.

“It has been very positive and well received,” she said. “Most people have been more than willing to take the health risk assessment because they know it will reduce their healthcare costs in the future.”

A Sag Harbor native, Hansen Morrissey said a lot of small businesses are also happy to be working with another small, local firm.

“We are not inventing any of this,” said Morrissey. “We are actually stealing these ideas from the best in the business.”

Morrissey said the concept is an open platform and companies like Safeway, which helped pave the way for this kind of healthcare management, are encouraging other businesses to adopt similar models. However, for an insurance brokerage to create a similar system is unique, said Morrissey.

“There is really nothing like it anywhere,” he said. “There are brokers out there that are marketing wellness programs, but no one we know of, and the University of Michigan has told us this as well, is really doing something like this.”

For employers with two to 50 employees, there are state laws that prevent insurance companies from giving a better rate to a “healthier” company and companies cannot band together to buy insurance. However, companies can band together to address an issue like creating healthier work environments on the East End, and eventually may be allowed to purchase insurance as a group.

“The reason our businesses are coming together is that they share the same philosophy that improving the health of our workforce will help reduce the cost of healthcare and should be a priority,” said Morrissey.

Morrissey Advisory Services is located at 39 Division Street, Suite C in Sag Harbor. For more information, call 899-4470.