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Hava Volterra

Hava Volterra

Posted: February 18, 2010 05:25 PM

Anthem -- Shifting Costs to Individual Policyholders

What's Your Reaction:

Today's Wall Street Journal editorial about Anthem's individual health insurance rate increases in California proves the point I made in my last post. Anthem is shifting costs from its group insurance plans to its individual insurance holders.

The WSJ editorial is clearly the result of information that Anthem supplied to the WSJ editorial board. In it, Anthem claims that it is forced to increase the rates for its individual plans because the state of California requires it to provide COBRA coverage (not unique to California) and because California mandates an 18 month extension to COBRA (CalCOBRA). This may be true, but COBRA is an extension of group insurance. If COBRA makes group insurance costlier, than the increases should be in group insurance, not on individual policies.

The article then goes on to claim that California forces Anthem to continue coverage even after COBRA has expired. That is patently untrue. However, I'll assume that it's just a mistake in wording, and that the reference here is the mandate to provide a "HIPAA" or "Guaranteed Issue" option for those seeking insurance after their COBRA runs out, something I wrote about here.

The article then claims that Anthem lost $58M last year on these Guaranteed Issue plans. That may be (although I'm skeptical), but even if it were true, let's analyze how much Anthem will be gaining through its recent rate increases:

The same WSJ editorial informs us that Anthem raised insurance rates by up to 39% on 700,000 individual customers. Other sources say the average increase was 25%. I'll make an assumption that this 25% increase amounts to at least $1,000 per year per policy holder. That's a very conservative estimate. Based on that, Anthem will be collecting an extra $700M in premiums this year from individual policy holders. Is it claiming that this is to make up for a $58M loss?

Anthem claims on its website that it has over 6.8 million California members. If 700,000 are on individual plans, then 6.1 million are on group plans. So a 25% increase in individual insurance rates can subsidize a 2.9% reduction in group rates. Or at least can mitigate the inflation in health care costs for group plans by that amount. For the record, large group insurance rates rose by about 10% a year in the past couple of years.

The other claim Anthem is making is that the recession has caused more people to drop their individual plans, making the cost of these policies higher. In fact, the opposite seems to be true. Anthem has decided to raise premiums on its individual plans in order to push individual policy holders out. It's doing that by shifting costs from its large group plans to its small group and individual plans.

Why is Anthem doing this? Why is it forcing individuals to subsidize large group plans? I don't know. But I do know the solution. The current mandate is that Anthem use at least 70% of the premiums it collects to pay for medical services. That mandate needs to be more specific. Anthem (and all other health insurance companies) needs to use at least 70% of the premiums it collects from individual policy holders to pay for individual policy holder medical care. It cannot shift the cost of medical care from groups to individuals. Yes, groups may have more lobbying power (in the form of corporate lobbying), but if individuals are forced to drop their health insurance we'll all pay the price.

 
 
 
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08:15 PM on 02/21/2010
Healthcare bill cannot predict the behavior of Consumer (patient), Providers (hospitals and doctors), Pharma, Insurers and others. Hence a detailed bill before Congress is a mistake. All CBO calculations are based on assumptions. Rather, the bill should lay down healthcare and fiscal targets which are important and achievable; with a well-defined time-line.

The Executive, irrespective of party, will monitor response to these targets and modulate regulations, to align the actual from the desired end-points. Important point in healthcare reform, this is an ongoing process and we have to be disciplined to be on the trend-line (+/- 5%). True healthcare reform involves change in life-style, social relations, and business practices in the healthcare industry (17% of economy).

Healthcare costs are paid by employers / economy. One goal of reform should be to make US economically competitive. To achieve this end-point, the healthcare cost should be tied to GDP which is now 17% of GDP. This cost is currently 30% above the next closest competitor in western economies. Stating well defined end-points will signal that shenanigans by any stakeholders in the healthcare-pie will not be sustained for long.

As I post this, I wonder, if US Congress fails in its attempt to pass a healthcare bill, why cannot states pass their own bill and by-pass the failed US House and Senate?
05:11 PM on 02/19/2010
Harry Reid go Harry he is pushing Public Option through reconcilation!!!
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eddiestardust
05:09 PM on 02/19/2010
I live in Pennsy and our Independence Blue Cross will raise my rate 44%:(

IF YOU FIND A HEALTH INSURER KICK HIM OR HER WHERE THE SUN DOESN'T SHINE!
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03:55 PM on 02/19/2010
I didn't read the editorial but LAT reported 800,000 members, and the anecdotal evidence is that rates are going up closer to $150/month, which means they are actually raking in DOUBLE the amount you calculated - close to $1.5 BILLION in rate HIKES alone for the individual market, to make up for the $58 MILLION they are claiming to "lose" in Guaranteed Issues, which, by the way are SUPER expensive and many are subsidized by the CA government.

Factor in that COBRA charges 100% of the premium they were collecting under the group plan (so not only are they not losing money, but they are keeping customers who would otherwise go uninsured), and you realize that the whole thing is being done for one reason and one reason only:

BECAUSE THEY CAN.

Our chickensh** legislature blinked HARD on regulating insurers, they smelled the blood in the water and they are on a feeding frenzy. Totally predictable, totally legal, totally immoral and totally destructive to hard working Americans.
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02:45 PM on 02/19/2010
I think it was back in the late 90's or in the first few years of this century, an AT&T executive was thinking about retiring and moving on to the next company he'd run into the ground. His bonus was of course based on earnings for the current quarter.

He decided to nearly double rates for existing off contract mobile plans and didn't inform many consumers. AT&T really knocked it out of the park that quarter before getting hammered into the ground the next one as customers walked away in droves. T tanked and never really recovered after that. I'd have to do my homework to find the name of the executive, think he went on to C to continue to pillage shareholders, but the moral of the story is that sometimes a massive increase in rates isn't anything more than someone trying to retire in style.
07:11 PM on 02/18/2010
Perhaps one of the reasons that Anthem is is raising rates at this level is because if the profits go up, the CEO and other executives can get huge bonuses. A few years ago Larry Glasscok the top executive at Anthem Blue Cross, received a 42.5 million dollar bonus on top of his multimillion dollar salary.

I have suggested that all compensation packages above 200 times minimum wage( which would be $3.0 million dollars) must be directly approved by stockholders. This will not immediately guarantee that these huge compensations will stop but I believe it is a democratic method to address this issue.

See : http://www.huffingtonpost.com/michael-blumenfield-md/huge-compensation-package_b_464678.html

Michael Blumenfield
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lisakaz2
Da ministero dell'interno di Snark.
07:08 PM on 02/18/2010
This doesn't surprise me. It's part of the way big insurance will squeeze the little guy while claiming it is extending coverage. I don't even get how COBRA loses money. I'm on COBRA and I still pay 35% of the cost. The government pays the rest; I thought that was the point of recent legislation. So I would have the same policy for $500+ per month. And they are getting it. Where's the loss?
05:44 PM on 02/18/2010
they don't want individuals. they want groups. they want to price us out. Actually, there should be ONE pool and allow only a 5% differential between groups and individuals. Oh sorry, then Congresspeople won't get their huge discounts. sorry. sorry.
This is why we need a single payer system. Or at the very least a public option open to all. Eventually these companies will be made to stop the price gouging or just go out of business.
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lisakaz2
Da ministero dell'interno di Snark.
07:09 PM on 02/18/2010
Congress don't get discounts. They have a public plan. They don't pay a cent.
08:03 PM on 02/18/2010
Congress doesn't have a public plan. They're insured by private companies and the different plans are administered by a federal agency. It collects the premiums and disburses them to the companies. Google Federal Employee Benefit Plan and it will give you the details. It's absolutely wonderful, great prices, great coverage - and completely off limits for the rest of us.

The federal benefits even include the HMO in my town and my rates is 4 times as much as the federal. That's the benefit of a very large group and they won't let us have it.
07:59 PM on 02/18/2010
Amen to that! I will never understand why there is any difference between coverage and premiums for groups vs. individuals. Individuals make up a very large group so what's the difference? The only one I can think of is that the billing and payment processing would be more expensivebut it's not a great deal of money with online billing and payment.