From: ABC News: Health
Democrats scramble after warning after health insurers say overhaul
will drive up premiums
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MA health Insurers Report Losses
Here is some news that will make health insurers throughout the
country a little nervous:Major health plans serving the
Massachusetts Connector all reported net losses in the first
quarter of 2010: Harvard Pilgrim Health Care ($27 million), BCBS of
Mass. ($65 million), Tufts Health Plan ($52 million) and Fallon
Community Health Plan ($8.5 million).As I noted in previous posts,
the premium requests by these same insurers were denied by the MA
DOI earlier this year. Obviously if these losses continue, some if
not all of these insurers will pull their products from the
Connector.Health care is extremely expensive in Massachusetts.
Reform there solved the problem of the uninsured but has yet to
slow down the high cost of care there.
Rising HC Premiums: It's Really Not the Insurers Fault
President Obama met last week with a group of major health insurers
to warn them against high premium increases. But what is often
ignored or forgotten on this issue is that premium increases are
often beyond the control of health insurers. Health care premiums
are primarily determined by the fees HIs negotiate with doctors and
hospitals. In areas where there are provider monopolies,
negotiating fees is obviously more difficult for HIs and premiums
there will be higher. So until provider fees are controlled, it
really is unrealistic to expect premium fees to do anything but
increase. It is well documented for example that doctors in the U.S
make significantly more than doctors in other countries. But
beginning a discussion of reducing doctors' fees is fraught with
political peril gi...
Recissions: The Actual Data
Nothing makes health insurers look more vile than the practice of
recission; revoking coverage and refusing to pay claims if the
insurer determines the covered individual was not honest when they
completed their health questionnaire. Wellpoint is the most recent
insurer to get \"raked over the coals\" for this practice. But how
often does this practice occur? According to an article in Kaiser
Health News:Rescissions are very rare. They apply only to the
individual market (less than 10% of private health insurance) and
even then they occur less than 4/10ths of 1% of the time. Even when
it does happen, there is almost always an appeals process where the
decision is reviewed by an internal committee and often submitted
to outside reviewers. Further, when insurers are wrong
– as they...
Feds Move to Regulate Premium Hikes
As I mentioned in my previous posts, there is concern that the new
market of customers created by health care reform will not be very
profitable. To compensate for this, it is thought that insurers may
start to unnecessarily increase the price of premiums in the next
few years. From the NY Times:Fearing that health insurance premiums
may shoot up in the next few years, Senate Democrats laid a
foundation on Tuesday for federal regulation of rates, four weeks
after President Obama signed a law intended to rein in soaring
health costs. After a hearing on the issue, the chairman of the
Senate health committee, Tom Harkin, Democrat of Iowa, said he
intended to move this year on legislation that would
“provide an important check on unjustified
premiums.†Mr. Harkin praised a bi...
