Thursday, April 15, 2010

The Massachusetts Model: Rate Wars

Just a peak into the future for the rest of you, America.

"The first time the state has used its authority to turn down health premium increases. The action immediately sent ripples through the state health care industry....

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Related:
The Massachusetts Model: Rates Rising Through the Roof

Also see: Challengers question Patrick motive for rate denials

So do I. He's had three years to do something, and all of a sudden at election time he gets up the nerve.

Pfft!


And here is what you have to look forward to, America:

"Health insurers sue to raise rates; Say state’s veto will cause huge losses; Showdown near on regulatory power" by Robert Weisman, Globe Staff | April 6, 2010

A half-dozen health insurers yesterday filed a lawsuit against the state seeking to reverse last week’s decision by the insurance commissioner to block double-digit premium increases — a ruling they say could leave them with hundreds of millions in losses this year....

That's why we wanted a decent single-payer system like France or Norway, not this abomination.

Yesterday’s legal action sets the stage for a showdown between state regulators and the health insurance industry.

While YOU GO WITHOUT HEALTH COVERAGE, Bay-Stater!

Governor Deval Patrick has made reining in runaway health care costs a centerpiece of his administration and his campaign for reelection — contending they are stifling the capacity of small businesses to create jobs. At the same time, health insurers argue that government is forcing them to sell policies at a loss that is unsustainable as the costs of medical services climb.

Yeah, two years after the recession he all of a sudden discovers small business and health care costs.

Filing the suit were Blue Cross and Blue Shield of Massachusetts, the state’s largest health insurer, and the five commercial members of the Massachusetts Association of Health Plans: Harvard Pilgrim Health Care, Tufts Health Plan, Fallon Community Health Plan, Health New England, and Neighborhood Health Plan. All are nonprofit carriers....

That just means they don't pay taxes.

The first time the state has used its authority to deny health plan increases....

The rulings mean that health insurance rates established in 2009 for small businesses and individuals will remain in effect — rates the insurers say were not even sufficient to cover last year’s costs. “What the commissioner did, we think, is going to create tremendous disruption in the marketplace,’’ said Dean Richlin, a partner at Boston law firm Foley Hoag who represents insurers.

I don't like my health being "marketed," thank you.

Health insurance leaders are also contending the health premium rate rejections are a distraction from what they see as the real problem: steadily rising medical costs, particularly from health care providers and hospital groups that use their market clout to negotiate long-term contracts on favorable terms with the insurance carriers....

See: Memory Hole: Why the Nation Doesn't Need Massachusetts Health Care

But state officials and insurance authorities act as if they can't figure out the problem.

Catherine Bromberg, a Massachusetts Hospital Association spokeswoman, said she was unaware of discussions between insurers and individual hospitals about reopening contracts.

Yeah, the only contracts you can't reopen are "public servant" pensions and perks or banker bonuses.

Everything else, RIP OPEN the STITCHES!!

Insurers are required to maintain financial reserves to cushion them against losses, but such reserves won’t protect them indefinitely if they are not permitted to cover their costs, the carriers said....

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Of course, it is ALL about YOUR HEALTH, right, readers?

"Insurers call halt, get state warning; New policies stopped in disputed category; Regulators demand resumption by Friday" by Robert Weisman, Globe Staff | April 7, 2010

The standoff between Massachusetts regulators and health insurance companies intensified yesterday, as most insurers stopped offering new coverage to small businesses and individuals, and state officials demanded that the insurers post updated rates online and resume offering policies by Friday.

People seeking to buy health insurance for the first time, or customers looking to change policies, found they could not do so, at least temporarily. The confusion — or market chaos, as one insurance industry official called it — followed the state Division of Insurance’s rejection last week of 235 of 274 premium increases proposed by insurers....

Insurance industry critics said the inability of new customers to buy insurance, even for a few days, is troubling....

I don't see them entering into the political back-and-forth or rest of this, so who gives a fuck?

Existing policies remain in place and are not affected by the move to stop offering new coverage. Insurers are required by law to notify state regulators 30 days in advance of discontinuing a product....

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"2 insurers to resume sales with old rates" by Robert Weisman, Globe Staff | April 8, 2010

Blue Cross and Blue Shield of Massachusetts, the state’s largest health insurer, and Tufts Health Plan said they will market the revamped policies on the state’s Health Connector website and through their own networks of independent brokers. Two other health insurance companies, Harvard Pilgrim Health Care and Fallon Community Health Plan, yesterday would not commit to offering new rates by tomorrow’s deadline, despite the insurance commissioner’s stern warning that the law requires them to do so.

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Having fun with all the back-and-forth, readers.

Hope you aren't hurt, ill, or sick.

And why not?

Let's drag some agenda-pushing POLITICS into it!


"
Baker increases fire on health; He had passed up chance to blast rate-cap ideas" by Noah Bierman, Globe Staff | April 8, 2010

GOP gubernatorial candidate Charles D. Baker has come out strongly against Governor Deval Patrick’s move to cap health insurance rates, calling it an “election-year gimmick’’ that would lead to the demise of several insurance companies.

Well, it is!

While Baker’s comments have framed the debate on a central issue in the governor’s race, his tone is new. He passed up several opportunities to criticize the idea before he became a candidate, and he served on a state panel that endorsed limiting rate increases by insurers as one potential strategy to combat rising health costs.

And Patrick's isn't, huh, Globe?

Sigh.

I'm so tired of the agenda-pushing bias in each and every article when they are giving us false choices anyway.

With health care dominating the political discussion, Baker, who ran Harvard Pilgrim Health Care until last year, and Patrick, the Democratic incumbent, have accused each other of doing too little in their respective roles to curb costs since Massachusetts initiated its universal health care plan in 2006. In fact, Baker’s involvement in state health care policy is more complicated than either man has conveyed.

From 2006 until last July, Baker was a relatively active member of a government committee, created under the health care law, to study how to improve health care and lower costs. The Health Care Quality and Cost Council, which worked closely with the Patrick administration, listed regulating insurance and health provider rates as a primary issue to study in a 2008 report.

In January 2009, after Patrick convened a separate group of top health executives to discuss reducing costs, Baker was asked by a Globe reporter about the governor’s suggestion that he might use state authority to hold down insurance premiums. Baker did not embrace the idea, but he did not dismiss it or warn of dire consequences either, as he has recently.

“We’re going to hold hearings around rates and whether or not they’re excessive,’’ Baker responded at the time, repeating a proposal he had endorsed earlier on the Globe’s op-ed page.

Asked specifically to comment on the state using its authority to regulate insurance rates, Baker said, “All of the carriers basically said we would welcome that kind of investigation, if that’s deemed an appropriate thing to do.’’

Baker’s campaign spokesman, Rick Gorka, said that Baker has been a consistent, active public voice in calling for more transparency in health care costs and that Patrick’s rate cap solution is short-term and politically motivated. He denied that Baker’s position or tone on the insurance cap issue had changed.

“It’s fine to do it,’’ Gorka said. But, he added: “You only get temporary relief. You don’t actually solve what’s going on. It’s sweeping it under the rug.’’

Gorka also noted that the state panel on which Baker served had listed insurance rate caps as one potential strategy for fixing health care within a document of more than 60 pages.

“There are a lot of ideas in here that are great ideas to reforming health care,’’ Gorka said. “Unfortunately, the governor has ignored 99 percent of them.’’

Doug Rubin, a senior adviser to the Patrick campaign, faulted Baker and other health care executives for failing to do more on their own to attack the cost problem. He said Patrick was hoping after the January 2009 meeting that industry leaders would reach a consensus on a solution.

“They never reached a consensus,’’ Rubin said. “What you’ve seen recently is the governor finally saying, ‘Look, we need to bring some relief to working families and small businesses.’ ’’

Well, where have you and your man been for three years?!!!

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Committee members and meeting minutes indicate that Baker was especially vocal on the need for greater transparency, under the theory that hospitals and other providers will face pressure as the public learns they often charge differing rates for similar procedures.

He's right on transparency; however, as for anyone listening to the public.... pfffft!

I've been waiting.

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Related: Pumping Up Governor Patrick

Baker the Bozo

Well, at least you know whose side the agenda-pushing paper is on, voters.

Just as long as you know you are being lied to and given tilted coverage.

Remember, Globe had Coakley winning by double digits in their polls.

Update: Insurers plead rate case; judge to rule by Monday

Stay well over the weekend, dear readers:

"
No end yet to insurance standoff; Hundreds still unable to buy from state site" by Robert Weisman, Globe Staff | April 10, 2010

Hundreds of individuals and owners of small businesses seeking to buy health insurance this week were turned away from the state’s Health Connector website as the standoff between insurers and Massachusetts regulators dragged into the weekend....

The rates in question apply to the small group market, a pool that includes individuals and small businesses.... While insurers were told to have their revised rates ready by yesterday, Connector spokesman Dick Powers said none submitted updated rates by the end of the day. Because it takes time for the Connector to load and test new rates on its software, he said, they aren’t likely to be available until the middle of next week at the earliest. The Connector was created by the state’s 2006 health care law to help people obtain coverage....

About 50,000 policies covering 200,000 members in the small group market — about a quarter of the entire market — were up for renewal April 1....

As they await Monday’s ruling from Neel, three health insurers yesterday said they also plan to file administrative appeals with the insurance division next week to contest the state rate rulings on two separate tracks. Blue Cross and Blue Shield, Fallon, and Tufts Health Plan will join a fourth insurer, Harvard Pilgrim Health Plan, which already filed an appeal. State Assistant Attorney General David A. Guberman argued in court Thursday that insurers should be required to exhaust the appeals process within the insurance division before turning to the courts.

So how much health care dough is this court bickering going to cost taxpayers?

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And the ruling?

"
Judge blocks insurers on rates; Companies to fight on against state regulators" by Robert Weisman, Globe Staff | April 13, 2010

A Suffolk Superior Court judge yesterday denied a request that would have let six Massachusetts health insurers go forward with double-digit rate hikes for tens of thousands of small businesses and individuals, setting up a protracted battle that could become a test of government’s role in controlling health care costs....

The case has focused a national spotlight on the tug of war between regulators and a health care system over mounting costs for consumers and businesses....

Yup, ready or not, here it comes, America!

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Yup, state is going to get tough with 'em after all this time!

State regulators yesterday demanded that health insurers submit revised April 1 premium rates for tens of thousands of individuals and small businesses by 3 p.m. tomorrow or face stiff fines.

The fines could run to as much as $5,000 a day per carrier, plus $1,000 for each consumer who is unable to buy coverage, according to a letter sent by Insurance Commissioner Joseph G. Murphy yesterday afternoon to Massachusetts insurers.

“Refusing to offer or issue policies to eligible individuals and eligible small businesses is disruptive to the small group market and a violation of applicable laws and regulations,’’ Murphy wrote.

We shall see if they follow through; I'm not getting my hopes up.

Once the campaign cash stops flowing they will change their tune and proclaim a victory.

The letter went out to six companies — Blue Cross and Blue Shield of Massachusetts, Harvard Pilgrim Health Care, Tufts Health Plan, Fallon Community Health Plan, Neighborhood Health Plan, and Health New England — the day after Suffolk Superior Court Judge Stephen E. Neel denied their request for an injunction that would let them implement double-digit rate hikes rejected earlier by insurance regulators.

Neel ruled that insurers should exhaust their administrative appeals within the insurance division before moving forward with court action against the state....

So how much are the taxpayers going to be out for the court cases -- money that could have gone for health care, right?

Yesterday’s letter followed mounting frustration by state officials over the insurers’ delay in following an order to update their quotes on the state’s Health Connector website and through other intermediaries that sell the companies’ insurance, using base rates from last year.

Yeah, how does it feel?

Not too good, huh?

Then why would you think we are liking it out here?

The insurers had posted new rates, with average base rate increases of 8 to 32 percent, on the Connector site, but were told by regulators to remove them when the rates were denied.

Representatives of the health insurers yesterday said they were working to comply with the state directive, but some stopped short of committing to having revised rates ready by tomorrow.

“The state has asked us to comply, and we expect that we will be in compliance,’’ said Jay McQuaide, vice president for Blue Cross-Blue Shield, the state’s largest health insurer.

“We’re doing everything we need to do to get the rates in place as quickly as we can,’’ said Fallon spokeswoman Christine Cassidy....

Yeah, sure.

As of 5 p.m. yesterday, the Connector had reposted only individual and family rates from one carrier, Health New England, for insurance products covering the small group market. The segment includes about 800,000 people. Connector spokesman Dick Powers said it could take a day or two to post rates after they’re submitted. Health New England serves Western Massachusetts....

Oh, the only ones who complied, huh?

Sigh.

Can we secede from Massachusetts now?

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Also see:

Also see: Boston Globe Omissions: Hiding Health Care Failure

Yeah, ENJOY, AmeriKa!!!!