Those extras will help insurers increase their MLRs. Yes, some insurers are paying lower sales commissions but that's one step among many that they are taking to boost their MLRs. Congress needs to give the system some time to work.
What Congress might really do
The House Energy & Commerce Committee's Subcommittee on Health held a number of hearings in 2011 on the issue of broker commissions and is itching to do something. Still, HR 1206, a bill to "preserve consumer and employer access to licensed independent insurance producers" has languished in the committee since March 2011. There doesn't seem to be a big legislative appetite beyond the subcommittee for this particular fight.
3.Give the IPAB a chance
The controversy that surrounds the Independent Payment Advisory Board has the makings of a great novel—with power, politics and money at center stage. IPAB is empowered to analyze the drivers of Medicare cost growth and then to recommend to Congress policies to control those costs, if spending exceeds a targeted growth rate.
The 15-member board, which will be named by the president and confirmed by the Senate, will be comprised of doctors, nurses, medical experts, and consumers. Supporters see IPAB as similar to Medicare Payment Advisory Commission (MedPac), but with the power to implement what it decides needs to be done. IPAB recommendations will be put in place unless Congress votes to block them and comes up with equivalent cost-cutting measures.