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Anthem Blue Cross’ Statement Justifying Rate Hike Contradicted by Internal Documents

Friday, 19 February 2010


“Tip of the Iceberg”

White House press secretary Robert Gibbs told reporters aboard Air Force One Thursday that Anthem Blue Cross’ planned rate hike is “very much the tip of the iceberg.”

“We’ve seen this happen throughout the country,” Gibbs said. “And without a concerted effort to drive down costs through comprehensive health care reform, more and more people across this country are going to open their mail, open letters from insurance companies, and realize that, regardless of what they did last year and, quite frankly, regardless of what health care spending does, they’re in for a big rate increase. And I don’t think that that’s what those individual policyholders have in mind.”

Gibbs highlighted a critical report released Thursday by Sebelius that said health insurance companies were also planning rate increases in Connecticut, Maine, Michigan, Oregon, Rhode Island, and Washington.

The report, Insurance Companies Prosper, Families Suffer: Our Broken Health Insurance System, is being used as way of drumming up support from lawmakers for the foundering health care bill. Indeed, the report contains a list of bullet points on why Congress should swiftly pass a health care bill. The administration also launched a website,, to tout its reform efforts and highlight the skyrocketing increases health insurance companies have planned.

“Premium hikes in California and across the country are a wakeup call,” Sebelius said. “It’s time for Congress to pass reform and hand control over health care decisions back to American families and their doctors.”

According to the report, “some of the premium increases requested by insurance companies are 5 to 10 times larger than the growth rate in national health expenditures.”

Additionally, the profit margin “for the ten largest insurance companies increased 250 percent between 2000 and 2009, ten times faster than inflation” and “recent data show that the CEOs of America’s five largest insurers were each compensated up to $24 million in 2008.”

“Last year, as working families struggled with rising health care costs and a recession, the five largest health insurance companies – WellPoint, UnitedHealth Group, Cigna, Aetna, and Humana – took in combined profits of $12.2 billion, up 56 percent over 2008,” the report states. “These health insurance companies’ profits grew even as nominal GDP decreased by 1 percent over this same time period.”

WellPoint earned a profit of $2.7 billion in the last quarter of 2009 alone.

The report released by Sebelius notes:

Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state.

Anthem in Maine had an 18.5 percent premium increase rejected by the state last year as being “excessive and unfairly discriminatory” – but is now requesting a 23 percent increase this year.

In 2009 Blue Cross Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market.

Regency Blue Cross Blue Shield of Oregon requested a 20 percent premium increase.

UnitedHealth, Tufts and Blue Cross requested 13 to 16 percent rate increases in Rhode Island.

Rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations.

Resurrecting the Public Option

Meanwhile, 17 Democratic senators have signed a letter calling on Senate Majority Harry Reid to “bring for a vote before the full Senate a public health insurance option under budget reconciliation rules,” which would only require 51 votes to pass.

“There are four fundamental reasons why we support this approach – its potential for billions of dollars in cost savings; the growing need to increase competition and lower costs for the consumer; the history of using reconciliation for significant pieces of health care legislation; and the continued public support for a public option,” the letter says.

Last month, during an appearance at the House Republican Conference in Baltimore, Obama described his health care plan as “pretty centrist,” a major point of concern for many of his supporters who have insisted that the package include, at the very least, a public option, or government-run plan, to compete with private insurers.

The public option was included in a version of the House bill passed last year, but stripped when the legislation reached the Senate in December.

[Byline Jason Leopold]

Full Article – Truthout

This is now, and it’s a mandatory tax-penalty.

More HillbamaCare Shock: Premiums Up 18-27%, Deductibles Soaring

Thursday, 16 May 2016

Reports continue to flow in of big ObamaCare premium spikes that will hit exchanges around the country in 2017.

Insurers are seeking an average 27% rate hike in Oregon; 21% in Maine; 18% in Virginia; and 18% in Florida.

But if the premiums don’t shock you, the deductibles very well might. Not only are bronze deductibles rising as high as $7,150 in 2017, from a maximum of $6,850 this year, but silver deductibles of $6,000 or more are becoming commonplace. In fact, Centene (CNC), one of the most aggressive exchange competitors when it comes to pricing, is planning to roll out a new silver plan with a $7,050 deductible next year under the Ambetter name — to go along with the $6,500-deductible silver plan it’s already offering. Amazingly, Ambetter had just a $1,750 silver-plan deductible in 2014.

Silver Deductibles Cut Bronze Subsidies

The problem for exchange shoppers is that ObamaCare premium subsidies are set based on the cost of the second cheapest silver plan in each market. The effect of Centene’s sky-high-deductible strategy is to scrunch down silver-plan premiums closer to the cost of a bronze plan and shrink the government subsidies that are supposed to help make coverage affordable. If customers don’t like the cheap Ambetter silver plans on offer, they’ll have less of a subsidy to buy a bronze plan or a silver plan from a competitor.

Thanks to Centene, the subsidy available to 30-year-olds earning $30,500, just over 250% of the poverty level, will shrink from about $627 this year to $571 next year in Indianapolis, an IBD analysis finds.

Centene pursued the same hard-nosed strategy this year, selling silver plans with bronze-like deductibles of $5,500 and $6,500 in Miami, Atlanta and Jackson, Miss. While its cheap silver plans have helped the company boost enrollment, it’s no coincidence that those three markets are the most expensive major markets on for buying subsidized bronze plans.

While Centene filings have only been made public for Indiana, Ambetter plan designs in the Hoosier State mirror those in Florida, Georgia, Mississippi and Washington state this year, so those states and others also may see $7,050 silver deductibles in 2017.

As IBD noted recently, Blue Cross of Idaho plans to offer a $6,850-deductible silver plan in 2017, which would make a pregnant woman pay $7,010 for delivery of her baby. Blue Cross of Idaho’s highest silver-plan deductible this year is $4,000. But after hiking premiums about 22% last year and being underpriced by competitors, the company may be turning to a much higher deductible as a way to hold down premium price hikes for 2017.

The story for Centene is much different. The company, which expanded from Medicaid managed care into the individual commercial insurance market with the launch of ObamaCare, is one of the few insurers making solid profits on the exchange. Although other insurers in Indiana are seeking double-digit price hikes, and Anthem (ANTM) has requested a 30% increase, Centene has proposed a 5.3% rate cut.

Aetna (AET), which saw its ObamaCare enrollment shrink from a year ago in the first quarter, filed to begin offering exchange coverage in parts of Indiana and will apparently start with the lowest-cost bronze plan on the market, just 3.6% higher than this year’s cheapest bronze plan. Yet because of the smaller subsidy, the after-subsidy cost of the cheapest bronze plan will rise 7.6%.

Aetna’s lowest-cost silver plan, by the way, will carry a $6,075 deductible, though the maximum out-of-pocket spending on medical services also will be capped at $6,075, below ObamaCare’s $7,150 maximum for 2017.

Some Benefits Covered

While the high silver-plan deductibles can leave people on the hook for huge expenses before insurers pay much in the way of benefits, they’re not as bad as they sound, because some benefits are provided before the deductible is met. Aetna’s plan charges $10 per primary care visit (excluding x-rays), $10 for laboratory tests and $5 for generics, but plan members are on their own for most big-ticket items.

Before Ambetter’s $7,050 deductible is met, members can pay $30 for a primary-care visit and $60 for a specialist; $15 for generics; $50 for preferred brand drugs; $100 for urgent care; $30 for prenatal and postnatal care; and $60 for diabetes management. But that still leaves huge holes for surgery, MRIs, specialty drugs; hospitalization and more.

Another important consideration is that the full deductibles only apply to individuals and families earning more than 250% of the poverty level. Those with lower incomes get extra cost-sharing subsidies — the subsidies that a federal judge just ruled have been funded without authorization and in violation of the Constitution.

But those subsidies are pretty meager for people earning between 200% and 250% of the poverty level. For this modest-income group, Aetna’s $6,075 deductible is only reduced to $4,875, while Centene’s $7,050 deductible is reduced to $5,250.

Centene’s high deductibles may be one reason that the company, unlike UnitedHealth (UNH), has said it didn’t experience any problems with people signing up for coverage midyear and running up big bills. People with urgent health needs are more likely to pay up for plan that limits out-of-pocket costs and provides a broad network of hospitals.

ObamaCare was supposed to balance risk among all insurers by transferring funds from carriers which attract low-cost customers to those that are a magnet for the sick, but risk-adjustment hasn’t worked as intended for a variety of reasons, including the failure to consider customer use of prescription drugs in weighing an insurer’s risk. Now the Obama administration is focused on making risk-adjustment work better, with uncertain implications for insurers’ profitability.

Source: New ObamaCare Shock: $7,050 Silver-Plan Deductible – Investor’s Business Daily

[Byline Jed Graham at Investor’s Business Daily]

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