What To Make Of Anthem’s Rate Hikes

HCAN has responded to Anthem Blue Cross’s rate hikes (the company is a subsidiary of WellPoint) in the California individual market by releasing a report demonstrating how premium increases have been feeding insurer profits, not paying for health care costs. “The report finds that the top five largest for-profit insurance companies increased their profits by $12.2 billion last year while dropping coverage for 2.7 million Americans“:

As a group, WellPoint, Aetna, UnitedHealth Group, Humana and Cigna saw their profits jump 56 percent in 2009 up $4.4 billion over the previous year, according to the report. Four out of five companies saw profits increase while insuring fewer people. Cigna increased earnings by 346 percent while UnitedHealth shed 1.7 million beneficiaries. Aetna, which increased its membership and percentage of premiums spent on medical care, was the only company to see less income in 2009 than 2008.

Health insurance is one of the only businesses where you can make more money by shedding customers and selling less product. And the insurers certainly have. The patchwork of state regulations governing the individual market allow insurers to cherry pick the healthiest applicants and drop those with the most expensive claims. It’s a smart business strategy but it doesn’t work very well for the patient, which is presumably a concern for lawmakers.

Democrats have responded by proposing a plan that establishes new standards for insurers and sets a federal floor of protections that prohibit some of the most egregious industry practices. You’ve heard most of this before: the legislation would prevent pre-existing condition exclusions, lifetime and annual limits, and other abuses. The bills “would greatly reduce the number of people enrolling in individual market plans. Instead of signing up for these high cost, low benefit plans, individuals can join together in a broader pool within the health insurance exchange to lower costs.” It’s a fairly good deal and according to the Congressional Budget Office, it should lower premiums for a good number of Americans and change the trajectory of health care spending (slow the growth of national health care expenditures).

And Republicans are also feigning concern. “If the argument is that the WellPoint hike means we need reform, well, ‘duh,'” said Michael Steel, spokesman for House Minority Leader John Boehner. “But our proposal holds down costs, without the trillion-dollar government takeover.”

No, their proposal reinforces the problems of the individual market. The House Republicans’ plan, which extends coverage to just 3 million Americans would leave 52 million Americans uninsured by 2019. And that’s because it deregulates the individual health insurance market by permitting insurers to override state-based consumer protections and sell sub prime policies across state lines. They want insurers to sell policies from the Northern Mariana Islands! In fact, it’s unlikely that the GOP would be able to qualify for coverage under their own plan — which, incidentally, does nothing to control general health care spending. (More on that here.)

So it’s a tale of two parties. Democrats are using the rate hikes to argue in favor of reform that would ameliorate the problem, Republicans are using it to hawk a proposal that would result in higher costs for the overwhelming majority of Americans. Republicans are trying to sell you the kind of deregulation that contributed to the rate hikes in the first place.


Anthem Blue Cross has “agreed to delay implementation of a planned rate increase until May 1, 2010″:

A spokesman for the Insurance Commissioner’s office told KCBS the company agreed to delay the rate hike, while state regulators conduct an actuarial review of the company’s finances…The company will have to prove to state regulators that 70% of the money it takes in, including the new revenue from the rate hikes, will be spent on health care benefits, rather than administrative costs or shareholders.

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