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Critics: Anthem Rate Hike Strategy Leaves Policy Holders in Dark
05/30/2012   Reported By: A.J. Higgins

Anthem Health Plans of Maine has announced a rate increase that will carry an overall impact of 1.7 percent for Maine consumers. While the number does not appear overly excessively, some health care advocates are saying Anthem's number-crunching is less than transparent. Consumers For Affordable Health Care maintain Anthem's increase was reached on a combined product line basis. And that makes it difficult to determine whether any of the company's individual insurance product increases exceed the 10 percent federal for unreasonable rate hikes.

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Critics: Anthem Rate Hike Strategy Leaves Policy
Originally Aired: 5/30/2012 5:30 PM

There's nothing new about Anthem Health Plans of Maine's decision to announce its rate increase based on a combined product basis of all the different insurance plans it sells. But Joe Ditre, of Consumers for Affordable Health Care, says a new federal law that became effective last September requires companies like Anthem to file its rates for each specific insurance product sold.

Because the company sells several insurance products in Maine, Ditre says it's hard to tell whether one or more are crossing a federal 10 percent threshold for reasonable rate increases when the company declares its overall rate increase impact for this year is only 1.7 percent .

"While the company's filing basically says that the overall impact is an average rate increase of 1.7 percent, it's absolutely impossible to determine what the rate of impact would have been if had they filed each of these products separately," Ditre says.

Ditre says changes to Maine's insurance regulations contained in Public Law 90 pushed through this past last year by majority Republicans do not require the state Bureau of Insurance to provide prior approval of insurance company increases.

"The result is that -- whether it was intended or not -- is that we as consumers don't know what the actual rate increase is for each specific product," Ditre says. "And therefore we don't know whether it actually is unreaonable because it would have exceeded the 10 percent threshold set by federal law."

Futhermore, Ditre says Public Law 90 will allow this rate increase to be shouldered by those on fixed incomes in upper age brackets who he says will see increases of up to 18 percent, while the smaller numbers of younger policy holders will see policy premium reductions.

Proponents of the new insurance law maintain that rates of all Mainers will go down because more younger and healthier uninsured consumers will be able to afford the lower premiums -- a claim Ditre rejects. "That's the lie of Chapter 90," Ditre says. "It basically promised that new healthy unisured people would come into the market and that hasn't happened."

"Ditre's point is simply not accurate," says Lance Dutson, executive director of the Maine Heritage Policy Center, a conservative advocacy group. "What PL 90 has done is to allowed insurance companies like Anthem to create products that better fit consumers."

Dutson says Ditre's Consumers For Afforable Health Care continues to push for a single-payor health care system that is opposed by most Republicans and that the group's criticisms of Anthem's 1.7 percent overall increase fail to recognize that insurance is becoming more affordable in Maine.

Dutson says some Mainers chose to remain with the policies they selected before Anthem's new product lines were released in order to avoid higher deductibles and coverage changes. As a result, he says those policy holders will not realize the savings that others are experiencing.

"Those people are not going to benefit from the changes as much as the new people that decide to reevaluate their insurance needs and purchase these newly tailored products," Dutson says.

Republicans and Democrats have sparred over PL 90 for most of the legislative session with Democrats claiming that Republican plan provides less coverage and can't deliver the savings promised. Republcians counter that Democrats need to give the new law a chance to work.


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