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BlueCross BlueShield of North Carolina's Desperate Attempt To Deceive

  |  Media Matters Action Network
Posted: 05-19-09 10:20 AM

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Media Matters Action Network:

BlueCross BlueShield of North Carolina Has A History Of Denying Coverage Due To Preexisting Conditions

BCBS Of North Carolina Implied Public Option May Not Cover Preexisting Conditions.  The Washington Post obtained storyboards of BlueCross BlueShield of North Carolina advertisements opposed to health care reform.  In a crowded gathering, the advertisement viewer will hear, "...pre-existing conditions? Nobody knows yet..." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

It is BlueCross Blue Shield of North Carolina that has a history of denying coverage due to preexisting conditions.

BCBS of NC: "Maternity Benefits And Preexisting Conditions Are Excluded." A BlueCross BlueShield of North Carolina press release announcing new coverage options stated, "maternity benefits and preexisting conditions are excluded, among other benefit limitations.  To apply for Short Term Health Care, a consumer must be a resident of North Carolina, under age 65 and not eligible for Medicare or Medicaid." [BCBS of NC Release via PR Newswire, 3/31/94]

BCBS Of North Carolina Denied Coverage To Applicants Due To PREEXISTING CONDITIONS.  As reported by the News & Observer: "In the world of individual health insurance, it doesn't take much to become undesirable. For Denis O'Connor, 61, of Chapel Hill, all it took was too many years without sunscreen and a few small skin cancers. For his wife Alice, 54, it was migraine headaches.  Those health conditions got the retired couple a health insurance quote of $3,000 a month -- $36,000 a year -- when they applied for a Blue Cross and Blue Shield of North Carolina plan in October 2003. They declined it." [News & Observer, 2/27/05]

After Wrongly Denying Coverage To Customers, BCBS Of North Carolina Was Forced To Pay For Medical Services.  According to the Durham Herald-Sun: "A state insurance department program launched in 2002 has forced North Carolina health plans to pay almost $1 million for medical services they had refused to cover.... Blue Cross and Blue Shield of North Carolina, the state's largest health insurer, had the second most cases reviewed at 28, of which 32 percent were overturned." [Herald-Sun, 5/22/05]

"Blue Cross And Blue Shield Of North Carolina... Said Denial-Of-Coverage Cases Really Are About Contract Interpretation." According to the Charlotte Observer, "Blue Cross and Blue Shield of North Carolina general counsel Brad Wilson said denial-of-coverage cases really are about contract interpretation -- whether an insurance policy covers a service or not. Consumer advocates argue that insurers use vague contract language as grounds to deny payment and save themselves money." [Charlotte Observer, 4/27/99]

Yes, Al Can Still See Dr. Ferguson

BlueCross BlueShield Of North Carolina Implied Public May Be Unable To Keep Their Current Doctors.  According to storyboards of a BlueCross BlueShield of North Carolina advertisement obtained by the Washington Post: "As the camera searches the room, or continues to narrow the frame after beginning at a wide focus, an older Hispanic woman comes into view. She's standing quietly in the middle of the action, as if she found herself at the wrong party, and doesn't know a soul. The background noise is dialed down significantly, enough to hear her say to no one in particular: 'Will somebody just tell me whether my Al will still be able to see Dr. Ferguson if we go through with this government plan?'" [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09;emphasis added]

President Obama: "Americans Must Have The Freedom To Keep Whatever Doctor And Health Care Plan They Have." While announcing a partnership to lower health care costs, President Obama laid out his vision for health care reform.  He said, "I'm also committed to ensuring that whatever plan we design upholds three basic principles: First, the rising cost of health care must be brought down; second, Americans must have the freedom to keep whatever doctor and health care plan they have, or to choose a new doctor or health care plan if they want it; and third, all Americans must have quality, affordable health care." [Obama Remarks via RealClearPolitics, 5/11/09]

BlueCross BlueShield Of North Carolina Says One Thing, Does Another

Says One Thing...

BlueCross BlueShield Of NC: "We Believe An Unchecked Government-Run Plan Would Lower Payment To Doctors." Discussing an upcoming ad campaign against health care reform with the Washington Post, BlueCross BlueShield of North Carolina spokesman Lew Borman said: "We believe an unchecked government-run plan would lower payment to doctors and hospitals, forcing them to attempt to charge private insurers more and thus further eliminate private insurers' ability to compete against the government." [Washington Post, 5/18/09]

Does Another...

BlueCross BlueShield Of North Carolina Lost $128 Million Lawsuit For Fraudulently UNDERPAYING DOCTORS.  As reported by the Durham Herald-Sun, "Blue Cross and Blue Shield of North Carolina was among 23 Blues plans across the country that Friday announced a $128 million settlement of a class action lawsuit brought by 900,000 physicians regarding the insurers' business practices. Numerous state medical societies, including the N.C. Medical Society, were involved in the lawsuit, which charged that North Carolina Blue Cross and other Blues plans harmed doctors with unfair business practices that denied and delayed payments for medical care... The complaint identified numerous Blue Cross and Blue Shield plans as defendants in an alleged scheme to defraud doctors in violation of the federal Racketeer Influenced and Corrupt Organizations Act (RICO)." [Herald-Sun, 4/28/07]

BlueCross BlueShield: Not One To Talk

BlueCross BlueShield Ad Implies Premiums Would Rise Under Public Plan.  According to storyboards of a BlueCross BlueShield of North Carolina advertisement obtained by the Washington Post, the viewer can overhear partygoers discuss "rising premiums." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

In Reality:

 Private Health Insurance Premiums Are Up 119% Since 1999, Compared To A 34% Increase In Wages.  According to the Kaiser Family Foundation, health insurance premiums have increased 119% since 1999, while workers' earnings have increased by just 34%.  [Kaiser Family Foundation, accessed 5/19/09]

Any Public Option Would Provide The Private Sector With Healthy Competition

BlueCross BlueShield Ad States The Health Care System Would Be Government-Run.  According to storyboards of a BlueCross BlueShield of North Carolina advertisement obtained by the Washington Post, the narrator says: "We need a plan for reform that will achieve the right results the first time around. We can do a lot better than a government-run health care system." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

House Democrats Are Committed To A Public Health Care Option Which Will "Spur Competition Within The Insurance Industry." The Hill reported: "[Majority Leader] Hoyer indicated that House Democrats are committed to including a public plan option in their bill. 'We believe that a public option clearly is going to be necessary' to provide consumers with an alternative to private insurance and to spur competition within the insurance industry, Hoyer said." [The Hill, 3/26/09]

 Senate Democrats Have Proposed That Public Health Care Should "Comply With All The Rules And Standards That Apply To Private Insurance" To Ensure That Private Insurance Can Compete.  According to the New York Times: "In an effort to defuse the most explosive issue in the debate over comprehensive health care legislation, a top Senate Democrat has proposed that any new government-run insurance program comply with all the rules and standards that apply to private insurance. The proposal was made Monday by Senator Charles E. Schumer of New York, the third-ranking member of the Senate Democratic leadership, in a bid to address fears that a public program would drive private insurers from the market." [New York Times, 5/5/09]

 Speaker Pelosi Is Looking For A Public Option To Make Private Insurers More Competitive. According to Bloomberg: "House Speaker Nancy Pelosi said the House this year will consider health-care legislation including an option for a government-run program that would compete with insurers. 'This is a big agenda, and I believe it should have a public option in it for it to be really substantial,' Pelosi told reporters at her weekly news conference in the U.S. Capitol. Pelosi said the Democratic-controlled House will be 'aggressive' in its approach to a health-care overhaul, which is a centerpiece of Obama's agenda. She said a government role in health care will help U.S. companies be more competitive." [Bloomberg, 3/26/09]

The Administration Advocates For Health Care Reform That Will "Reduce Long-Term Growth Of Health Care Costs For Businesses And Government." According to the White House: "The Administration believes that comprehensive health reform should:

  • Reduce long-term growth of health care costs for businesses and government
  • Protect families from bankruptcy or debt because of health care costs
  • Guarantee choice of doctors and health plans
  • Invest in prevention and wellness
  • Improve patient safety and quality of care
  • Assure affordable, quality health coverage for all Americans
  • Maintain coverage when you change or lose your job
  • End barriers to coverage for people with pre-existing medical conditions"

[WhiteHouse.gov, accessed 5/11/09]

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Filed by Media Matters Action Network