Anthem asked to justify increase

iVillage Member
Registered: 08-30-2002
Anthem asked to justify increase
17
Tue, 02-09-2010 - 8:56pm
But we don't need no stinkin health care reform.

 

Pfffft.

 


By SHAYA TAYEFE MOHAJER, Associated Press Writer Shaya Tayefe Mohajer, Associated Press Writer – 45 mins ago


LOS ANGELES – For the second time this week, President Barack Obama has pointed to one health insurer's major rate hike in California as a doomy harbinger of rising premiums across America.


Anthem Blue Cross' 30 to 39 percent rate hike in California will affect an unknown number of its 800,000 individual policyholders — the insurer has declined giving specifics. But Obama said the rate hike is a sign of what will happen to many Americans without reform.


"Premiums will continue to rise for folks with insurance, millions more will lose their coverage altogether, our deficits will continue to grow larger," Obama said Tuesday at a White House briefing. He also name-checked the rate hike in a CBS News interview on Sunday, citing it as a reason Congress should advance stalled health reform legislation.


Calling for bipartisanship and renewed effort on both sides of the aisle, Obama told reporters that "without some action on the part of Congress, it is very unlikely that we see any improvement over the current trajectory" of rising premiums.


House Committee on Energy and Commerce Chairman Rep. Henry Waxman, D-California, and subcommittee Chairman Rep. Bart Stupak, D-Michigan, announced a congressional hearing will be held Feb. 24. In addition to information from the company on its rate increases, testimony has been requested from Angela Braly, the president and CEO of Anthem's parent company, WellPoint Inc.


In a Tuesday post to the White House blog, Health and Human Services Secretary Kathleen Sebelius repeated demands that Anthem, California's largest for-profit health insurer, answer questions on how much profit the insurer will reap from the hike. Sebelius issued a sternly worded letter to the company on Monday.


California Insurance Commissioner Steven Poizner announced an inquiry into the rate hike on Monday, which doesn't require the state's approval, to ensure that it abides by state regulation and 70 percent of income from premiums will be directed to medical costs.


In an interview Tuesday with the Associated Press, Poizner said Anthem had not responded to his letter, adding the insurer "would be quite wise to postpone their rate increase" until after his department's review.


"Anthem Blue Cross, or any health insurance company, can't pick and choose who to raise prices on," said Poizner. "Part of our analysis of what Anthem Blue Cross is doing is we're going to make sure they're not discriminating" against a segment of their customer base.


Anthem also has not issued response to Obama or his administration. In a statement Monday, the insurer blamed the weak economy and rising health care costs for its rate hike, while pledging to reply to Sebelius' query promptly.


Health insurance analysts agreed that the rise in individual premiums will be echoed on a smaller scale in the rest of the marketplace. Employer-based insurance and group policies will likely see 10 to 20 percent increases in the next year, said health industry consultant Robert Laszewski.


About 13 million Americans purchased health insurance through the individual market in 2008, the most recent data available. Surges in their premiums can be explained by competing interests: Insurance companies are working to maintain earnings expectations in the face of rising costs, while rising premiums are driving healthy people to drop coverage, Laszewski said.


California's Democratic Sen. Dianne Feinstein on Tuesday called the rate hike unconscionable, saying it was proof of the need for reform. She also called for Congress to remove the health insurance industry's antitrust exemption "to ensure a fair, competitive market is not dominated by a handful of companies."


Various insurers have mandated rate hikes on individual policies across the country in recent years, though California's increase is larger than most. Last month, Anthem Blue Cross and Blue Shield filed for a 23 percent rate hike on 11,066 individual policies in Maine. In November, Oregonians holding individual policies with Health Net Health Plan of Oregon faced a 22.8 percent hike.


The Los Angeles Times first reported the California rate hikes last week. Anthem notified customers that rates would go up beginning March 1 and might start increasing more frequently than the usual annual increases. The company declined to provide details on the rate increases, such as how many people would be affected or how much the new rates would be.


It's also not clear whether customers in other states are being affected.


Indianapolis-based WellPoint is the largest commercial health insurer based on membership. It operates Blue Cross Blue Shield plans in 14 states and Unicare plans in several others.



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iVillage Member
Registered: 02-19-2008
Tue, 02-09-2010 - 10:39pm

California has taken action against insurance companies who terminated contracts on people who lied about their medical condition prior to purchasing a policy.

Usually when someone lies on a health insurance application, and runs up high bills, an investigator looks for evidence of an undisclosed prior condition. If found, this would violate the contract. The premiums are refunded, and no coverage is paid to providers.

California decided to pressure health insurance companies to continue to cover those who lie on applications. The result is higher premiums.

Coverage costs a lot more than insurance. People who wait until they need significant benefits before applying for coverage, will have a significant impact on what used to be insurance rates.

This is an inevitable consequence of California's populist policies.

iVillage Member
Registered: 03-30-2007
Wed, 02-10-2010 - 12:51pm

How dare anyone cross the insurance companies. Now you will be punished. Your rates are going up and if you even think about Heath Care, Your rates will go up again.

Who didn't see this coming a mile away?

iVillage Member
Registered: 01-22-2010
Wed, 02-10-2010 - 1:30pm
The industry runs the system. The industry has swayed public opinion, media perspective, and government decision. Be prepared to live with the industry's gun to your head.
iVillage Member
Registered: 08-30-2002
Wed, 02-10-2010 - 1:38pm

What is interesting is that Anthem is one of the suppliers in the state high risk pool. They create the rejects, that then have to apply to the state high risk pool, then they insure them, all "subsidized" by government funds. They can charge the individual up to $1,000 a month, for pretty dismal coverage. The state pays another 40% to Anthem. Seems like a pretty good racket to me.


I always wonder why people aren't bothered by this kind of corporate welfare, but have issues with people with PE conditions, who just



iVillage Member
Registered: 03-30-2007
Wed, 02-10-2010 - 2:45pm

Yeah, I'm getting ready to go 3 rounds with the insurance co. They keep telling me I have to use the generic. I am allergic to it. I was 10 years ago, 5 years ago, 1 yr. ago, 6 months ago, 3 month ago. I don't understand what is so hard to understand about that.

I doubt my son will ever be able to get regular insurance. Right now he has nothing.

iVillage Member
Registered: 08-30-2002
Wed, 02-10-2010 - 3:03pm

**I don't understand what is so hard to understand about that.**


Well...if you die of anaphalaxis, then they won't have to pay anything at all. It's being cost effective. "What is so hard to understand about that?"


(Please note sarcasm. I



iVillage Member
Registered: 03-30-2007
Wed, 02-10-2010 - 3:16pm
Oh, I know. I get so tired of all their BS.
iVillage Member
Registered: 08-30-2002
Sat, 02-13-2010 - 6:47pm

Rates increase in four states.


http://news.yahoo.com/s/ap/20100213/ap_on_he_me/us_insurance_rates_states



Individual insurance rates soar in 4 statesAP








Anthem Blue Cross, a subsidiary of WellPoint Inc., has been under fire for a week from regulators and politicians for notifying some of its 800,000 individual policyholders in California that it plans to raise rates by up to 39 percent March 1.


The Anthem Blue Cross plan in Maine is asking for increases of about 23 percent this year for some individual policyholders. Last year, they raised rates up to 32 percent.


Kansas had one recent case where one insurer wanting to raise most individual rates 20 percent to 30 percent was persuaded by state insurance officials to reduce the increases to 10 percent to 20 percent. The insurance department would not identify the company but said it was not Anthem.


And in Oregon, multiple insurers were granted rate hikes of 15 percent or more this year after increases of around 25 percent last year for customers who purchase individual health insurance, rather than getting it through their employer.


Premiums are far more volatile for individual policies than for those bought by employers and other large groups, which have bargaining clout and a sizable pool of people among which to spread risk. As more people have lost jobs, many who are healthy have decided to go without health insurance or get a bare-bones, high-deductible policy, reducing the amount of premiums insurers receive.


Steep rate hikes in this sliver of the insurance market — about 13 million Americans, as of 2008 — have popped up sporadically for years. Experts see them becoming increasingly common.


"You're going to see rate increases of 20, 25, 30 percent" for individual health policies in the near term, Sandy Praeger, chairwoman of the health insurance and managed care committee for the National Association of Insurance Commissioners, predicted Friday.


Most states don't have the legal authority to block or reduce health insurance rate increases, Praeger noted.


"When you see stories like (Anthem's), you can almost guarantee there's going to be increased consumer protection activity" in state legislatures, she said.


Her group doesn't track rates state by state, but Praeger said it likely will start doing so, "if we don't get any kind of meaningful reform at the federal level."


Politicians and even some health insurers, including Anthem, are urging a revival of the stalled effort in Congress to overhaul the health care system, arguing everyone needs to be covered by health insurance in order to prevent such premium spikes.


In Maine, where Anthem dominates the market, its proposal has several consumer groups planning big rallies at two public hearings on the rates, on Feb. 22 and 24.


Under Anthem's proposal, a family of four could be charged up to $1,876 per month if the proposed rates are allowed to take effect in July.


"The rate request should be denied on its face. It's outrageous," said Greg Howard, spokesman for Maine Change That Works. "We are in the middle of ... this record-breaking type of recession, and they're doing what they need to guarantee profit margin."


On Friday, Maine House Speaker Hannah Pingree and Senate President Elizabeth Mitchell wrote to two congressmen who have scheduled a Feb. 24 hearing on Anthem's pending rate hikes in California, asking them to also look into the proposed hike in Maine.


"We frankly have been very frustrated by the size of these increases," Pingree told The Associated Press. "Obviously, they are attempting to price certain people out of the market."


Last year, Maine's Superintendent of Insurance Mila Kofman rejected Anthem's initial requests, which would have increased individual rates an average of 18.5 percent. She allowed an average increase of 10.9 percent, with the highest increase at 32.4 percent.

Anthem sued the state. Oral arguments in the case are to be scheduled before the Maine Superior Court for mid-March.

Anthem spokesman Chris Dugan said Friday evening the company wants the court to review Kofman's decision because it didn't allow the company an operating profit. He said the rates requested for 2010 are needed "to make sure that we have adequate resources to cover the remaining members" in the insurance plans.

WellPoint, based in Indianapolis, has said it needs to raise rates so much because the weak economy has resulted in fewer people remaining in the individual market in California, and many who do have serious health problems. It says costs of caring for them have been rising due to higher provider prices and more use of diagnostic tests.

In Oregon, state insurance officials have concluded that rising costs justify the higher individual premiums, particularly because most insurers cut rates too much in 2006 and then got hit with significant losses. So double-digit increases, some 25 percent or higher, have been approved, or reduced a bit from 2007 to 2010.

Insurance Division spokeswoman Cheryl Martinis said the agency has started posting details of all proposed increases on its Webspace site and e-mailing customers want a proposal comes in so they can comment.

"People are extraordinarily upset in Oregon, as they are nationwide, about health care costs," she said.



iVillage Member
Registered: 11-17-2009
Sat, 02-13-2010 - 9:49pm

(( They keep telling me I have to use the generic. I am allergic to it.))

As a pharmacist, I am puzzled by this. You couldn't be allergic to the active ingredient...for they must be the same. Almost all states mandate bioavailability and bioequivalency data to be the same for generic and brand name. It could be that you are "allergic" to an inert ingredient such as a filler or a dye.

I am sure that they will allow you to use the brand name drug....you just have to pay for it.

I would ask your pharmacist to find another generic drug that you can try.

Without getting too personal, if you want to tell me the drug...maybe I can help you. If not...that's okay too....I realize it's personal information and many people don't want to post it all over the net. Just trying to help.

iVillage Member
Registered: 03-30-2007
Sun, 02-14-2010 - 9:21am
Not every medication is ingested. I will not discuss my medical problems on a message board. I will say it's been shown that it's the filler.

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