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Planet Money
2:34 am
Fri June 29, 2012

After Years Of Uncertainty, A Health-Care Business Gets An Answer

Originally published on Fri June 29, 2012 8:59 pm

It's 9:45 a.m. Thursday at the headquarters of Health Plan One, a health insurance agency that sells private policies. It's the morning of what is the biggest court decision ever regarding health insurance. Will the court uphold the health-care bill? Will it strike it down?

"Either way is fine with me," says Bill Stapleton, the company's CEO.

Stapleton is a man who is worn out. He spent years watching Congress debate the health care overhaul, gaming out how his company could survive under this version or that version. And then the law was passed and then the constitutionality challenged.

"It's very difficult to plan because there's so much uncertainty out there," Stapleton says. "That doesn't sound like a big deal. It's a big deal. How do you make an investment today? Your investment doesn't pay off today. It pays off in three or four years."

It's 10 a.m. Someone gets the TV working, and there's Wolf Blitzer on CNN announcing that the court has struck down the insurance mandate. Then Stapleton walks over to one of his salesmen, who tells him Yahoo is saying the bill has been upheld.

This kind of confusion, Stapleton says, is actually typical of how the past few years have been.

Eventually, the news is clear: The law was upheld. And unless Stapleton's company dramatically changes what it does, it has just been written out of existence. And not by the controversial parts of the law, but by the parts of the law most everyone likes.

For instance: Insurance companies have to reduce administrative costs. Stapleton's agency collects fees from insurance companies. His business is an administrative cost.

And starting in 2014, the law says insurance companies will not be allowed to deny people for pre-existing conditions. And at some point, people won't need to go through an agency like Stapleton's at all; the law creates online exchanges to buy insurance.

Stapleton says he's thinking about getting into life insurance. Or maybe car insurance or home insurance — anything that moves him away from the individual health market.

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.

Transcript

LINDA WERTHEIMER, HOST:

The health care law will mean major changes for companies in the individual insurance market. For some, it's the opportunity to find new customers. For others, it could be the end of the line. Planet Money's Chana Joffe-Walt spent yesterday waiting for the big decision with an insurer who must now consider switching to a business outside the health industry.

CHANA JOFFE-WALT, BYLINE: It's 9:45 Thursday morning at Health Plan One headquarters, a company that sells private health insurance policies. So it's a room full of people who sell health insurance on the morning of what is the biggest court decision regarding health insurance ever. Will the court uphold the law, will it strike it down?

BILL STAPLETON: Either way is fine with me.

JOFFE-WALT: Bill Stapleton is the CEO of the company.

Do you think other people in your office here are paying attention to this at all?

STAPLETON: I don't. I don't.

JOFFE-WALT: The level of disinterest in this office seemed curious to me. At 10 am, when the ruling was supposed to come out, Bill Stapleton was telling me about innovative software systems for medical underwriting. And I asked: Aren't you even going to look at the ruling? Watch the news or something? At which point Stapleton stood up and said, ah, let me see if that's possible.

STAPLETON: Hey Justin, it's Bill. Does the TV in the conference room, does that - can that play television? Can you turn the television on there?

JUSTIN: No. There's no cable. It's just whatever's (unintelligible).

STAPLETON: Anybody else have a TV?

JOFFE-WALT: It was not until Stapleton and I were standing in the conference room, with the TV on - for my benefit - that I realized this is not a man who doesn't care. This is a man who is worn out. Stapleton spent years watching Congress debate the health care overhaul, gaming out how his company would survive under this version of the bill, and that version. And then the law was passed, and then the constitutionality of the law was challenged.

STAPLETON: It's very difficult to plan, because there's so much uncertainty out there. And that's - that doesn't sound like a big deal. It's a big deal if you can't plan out two or three or four years, how do you make an investment today? You know, you're investment today doesn't pay off today. It pays off in three or four years.

JOFFE-WALT: Speaking of uncertainty. So Justin gets the TV working - and then there is Wolf Blitzer on CNN announcing that the court has struck down the insurance mandate.

STAPLETON: Struck down the individual mandate...

WOLF BLITZER: ....dramatic moment...

JOFFE-WALT: Of course, this information is wrong - CNN jumped the gun - but Bill doesn't know this. So he walks over to one of his salesmen, Dan Moncherry, who turns to his computer.

DANIEL MONCHERRY: Yahoo is saying it has survived.

STAPLETON: We have two conflicting reports here. This is unusual. Go to say Fox News.com or another station just to see what they say.

MONCHERRY: I don't know who to trust, right now, at this point.

JOFFE-WALT: This, Stapleton says, this is actually how the last few years have been for us.

STAPLETON: This is ironic. Very ironic.

JOFFE-WALT: Eventually, the news was clear, the law was upheld and it seemed, for Stapleton, like it was a final conclusion of sorts. Unless his company dramatically changes what it does, it was just written out of existence. And not by the mandate or by the controversial parts of the law - but by the parts of the law most everyone likes.

For instance, insurance companies have to reduce administrative costs. Bill's business is based on broker fees from insurance companies, so he's an administrative cost.

And, in 2014, the law says insurance companies will no longer be allowed to deny people for pre-existing conditions. Something that the salesman - Daniel Moncherry - spends a lot of his day doing on the phone.

MONCHERRY: Mm-hmm. When's the last time you had health insurance? 2010. So you've been without coverage two years. That's about right? How's your health right now?

JOFFE-WALT: In 2014, Moncherry won't be asking that question anymore. And at some point people shouldn't have to call him because the law creates online exchanges to buy insurance.

After the confusion about the ruling was cleared up, Moncherry and Stapleton were quiet for a couple minutes.

So what are you guys going to do now?

STAPLETON: We're thinking about a lot of things. And we're testing a lot of things right now to see what is interesting. For instance, life insurance.

JOFFE-WALT: Or car insurance, he adds, home insurance. Anything that moves us away from the individual health market.

(SOUNDBITE OF MUSIC)

WERTHEIMER: This is MORNING EDITION, from NPR News. Transcript provided by NPR, Copyright National Public Radio.