(The following is for study only and has NOT been approved by the Board
With the incoming Obama Administration putting healthcare reform as a top
priority, is it time for C.A.R. to look past the issue of SBHP and the
basic concept of “affordable healthcare”?
The Healthcare Working Group will be bringing a proposal to the Federal
Issues Committee for consideration.
The debate on healthcare is about to take the national stage again.
The incoming Obama Administration has made it clear that along with an
economic stimulus package, one of their top priorities will be a major
reform of the healthcare system. Former Senate Majority Leader Tom
Daschle has been nominated to be the Secretary of Health and Human Services
as well as appointed to be the new leader of the White House Office of
At the October 2008 C.A.R. Business Meetings the Federal Issues Committee
formed a Healthcare Working Group. This working group was charged
- Developing policy guidelines on healthcare issues that can be used to
evaluate legislation as it is introduced.
- Analyzing legislation as it is introduced and reporting their
recommendations to the committee.
With the issue of healthcare reform being addressed early in the upcoming
Administration, the working group has met several times to put together a
policy recommendation which will be brought to the Federal Issues Committee
at the January 2009 C.A.R. Business Meetings.
There are several intricate issues whenever it comes to healthcare and
options. However, most of these issues can fall into three main
categories. The first area of debate is over cost versus
mandates. Everybody wants to be able to get their insurance for an
affordable price, but they also want it to cover multiple variables and
issues. There is a debate on whether more mandates and coverage
increase the cost of health insurance or whether the true increases come
from other areas.
The second debate focuses on how many varieties of plans should be
offered. The more options for plans, the more likely it is for people
to find what they want instead of just what suits them the closest.
However, the more options means more administrative work and can also lead
to an increase in costs and can creep into the area of providers trying to
offer lower costs plans that do not cover many issues and are not of use to
patients in time of need.
Finally, there is the issue of how to spread the cost sharing and
burden. Often times the pivotal point of group plans is that the
costs and burdens are shared by the entire group. However, this can
also lead to the problem of the younger and healthier not wanting to join
these groups as they may be more expensive then they can find
privately. Should all costs and burdens be shared across the
group? Should certain behaviors or attributes increase the costs for
the individual instead of the group? These issues are important as
they can determine the longevity and the overall health of the group plan.
When it comes to healthcare and REALTORS®, the focus has been on
Association Health Plans (AHP) and Small Business Health Plans
(SBHP). As the issue has progressed, NAR and REALTORS® have moved
away from AHP and instead focused on SBHP as they provide a larger pool of
participants and help spread the risk beyond just REALTORS®, traditionally
a higher premium demographic. These plans have been met with
resistance for a variety of reasons. The new administration and
Congress seem prepared to look at overall healthcare reform instead of
piecemeal plans, such as a SBHP.
The last major attempt at healthcare reform came under the Clinton
Administration and was seen as a failure as it collapsed under its own
weight of detail and trying to solve all problems for everybody.
There was also a massive public relations campaign against the program by
those who had a vested interest in keeping the current profitable system in
In the past, C.A.R. has not lobbied for SBHP because they would have been
more restrictive and possibly harmful to the current SBHP that the state of
California offers, but C.A.R. remained neutral on them. C.A.R. had a
self-funded REALTOR® insurance pool in the past and it was a devastating
experience when it was forced to fold and many REALTORS® lost
coverage. While REALTORS® have always been for “affordable
healthcare”, most REALTORS® have found that recent attempts at “affordable
healthcare” have been anything but affordable.
Finding a suitable healthcare solution that would protect REALTORS® options
and allow them a variety of healthcare choices would have the potential to
give REALTORS® reduced healthcare costs and a wider variety of
alternatives. REALTORS® being part of a strategic and fundamental
reform of the healthcare system would allow us to be an advocate for small
businesses and the self-employed.
When dealing with overall reform, everybody stands to benefit in some areas
and everybody stands to potentially have areas they disagree with. A
piecemeal plan allows each group, such as a SBHP, to try to get what they
want. While this may not benefit the system as a whole or bring about
true reform, it can benefit one group over the other. Fundamental change
will mean that while REALTORS® will see some increased benefits, there
could be areas where we see decreased coverage or policies that we would
not traditionally support.
Impact on REALTORS®:
Healthcare has always been a substantial issue for REALTORS®. Since
most REALTORS® are independent contractors, it can be harder to find
affordable insurance. Another issue is that REALTORS® tend to have
higher premiums as an industry. Finding a solution for all REALTORS®
could provide a substantial alternative to private insurance and bring
relief to REALTORS®.
At the May 2008 Mid-Year NAR meetings, a motion was passed: "That NAR adopt
the following health policy principles recommended by the Insurance Task
1. The nation and its health care system are best serviced by having all
citizens covered by health insurance.
2. Health care coverage and/or insurance should be made available to
3. Individuals should have health care coverage that is continuous,
i.e. allows for no gaps in coverage.
4. Individuals should have the ability to choose their preferred
health insurance plan from an array of policy options that offer choices in
the scope of covered services and policy costs.
5. Health care coverage should enhance health and well-being by
providing preventative health services and chronic disease management
6. The health care delivery system must provide cost effective,
quality care in an efficient and timely manner in order to be affordable
and sustainable for society. Cost containment, therefore, must be a
component of any reform effort.
7. A "single payer" health care system in which the government pays
for and allocates health care services should be opposed.
8. Employers should not be required to offer employee health
C.A.R. has taken a "NEUTRAL" position on past association and small
business health plan legislation.
With the incoming Obama Administration putting healthcare reform as a
top priority, is it time for C.A.R. to look past the issue of SBHP and the
basic concept of “affordable healthcare”?