Anthem Bites Dust in Maine -again

[Winter_123]

Note the judge's rationale to wit the carriers are not guaranteed a profit. It used to be that that principle meant that the vagaries of the marketplace meant that a carrier could not necessarily be guaranteed a profit. What the judge is really saying is that the carriers cannot be guaranteed that the state (or feds, but I digress) will allow a profit.

This just basic public utility regulation which is what health insurance is now.

Change you can believe in.

Maine Court Backs Regulators in Anthem Rate Dispute - WABI TV5

 

[Crabcake Johnny]

Don't misconstrue my opinion as being for the decision. I'm against it, however the judge is correct. Show me any state law that guarantees that a company earns a profit.

 

[Winter_123]

Don't misconstrue my opinion as being for the decision. I'm against it, however the judge is correct. Show me any state law that guarantees that a company earns a profit.

WTF. Where did that little piece of commiedom come from? The carriers are not looking for a guaranteed profit. They are just looking for a chance to make a profit unimpeded by the state and the judge is not necessarily correct until the appeals courts have done their thing.

One can argue that the state has a valid interest in protecting the pubic from gouging. Fair enough. That why the carrier is required in Maine and elsewhere (increasingly) to demonstrate loss/payout ratios. Now the state is saying, "okay you did that but you are making profit elsewhere so we are going to cap you in that block."

If think that kind of thing is good or right, then you are all set because that is what it is going to be wall to wall in this country very shortly. For the states that do not have MLR's or do not yet require state approval for premium increases, let me give you a clue. It is all a ruse. You jump through those hoops and they will backfill with some new ones that they pull out of their collective arses after looking at the carriers books to decide what the right level of profit is for them.

Change you can believe in.

 

[somarco]

One of two things will happen.

Anthem will continue to write business only if they believe they can at least break even. It might even involve using new plans with lesser benefits which is tantamount to a "silent" rate increase.

Or, they will pull out of the state.

Either way the consumer loses.

John is right, even though he is trying to suppress his pinko personality.

 

[Crabcake Johnny]

WTF. Where did that little piece of commiedom come from? The carriers are not looking for a guaranteed profit. They are just looking for a chance to make a profit unimpeded by the state and the judge is not necessarily correct until the appeals courts have done their thing.

One can argue that the state has a valid interest in protecting the pubic from gouging. Fair enough. That why the carrier is required in Maine and elsewhere (increasingly) to demonstrate loss/payout ratios. Now the state is saying, "okay you did that but you are making profit elsewhere so we are going to cap you in that block."

If think that kind of thing is good or right, then you are all set because that is what it is going to be wall to wall in this country very shortly. For the states that do not have MLR's or do not yet require state approval for premium increases, let me give you a clue. It is all a ruse. You jump through those hoops and they will backfill with some new ones that they pull out of their collective arses after looking at the carriers books to decide what the right level of profit is for them.

Change you can believe in.

I guess you missed this part of my post:

Don't misconstrue my opinion as being for the decision. I'm against it,

 

[Winter_123]

I guess you missed this part of my post:

Don't misconstrue my opinion as being for the decision. I'm against it,

Oh, I saw "the judge is correct part." He is not. There is no basis in law for reaching that conclusion. The DOI simply has become a tribunal that judges what the correct amount of profit or lack thereof might be EVEN IF THE CARRIERS MEET THE STATUTORY CRITERIA FOR REQUESTING A RATE INCREASE.

Of course, if Anthem prevails on appeal then the legislature will simply amend the law to give the DOI complete discretionay power over what a carrier should be making or not be making if they have been good or bad nationwide. As I said, get used to it. Coming nationally.

 

[Crabcake Johnny]

Ok, let's play devil's advocate. What if Anthem was requesting a 65% increase stating that they expected to make a certain profit. Then what.

 

[GreenSky]

Ok, let's play devil's advocate. What if Anthem was requesting a 65% increase stating that they expected to make a certain profit. Then what.

What part of a free market do you not understand?

We finally have to realize that big governement and the nanny state is the root of all evil. That and organized religion.

Rick

 

[Crabcake Johnny]

Actually Rick I totally agree. I was indeed playing devil's advocate. I'm not a fan of the gov't telling companies what they can and can't charge for their services. If Anthem's Maine customers decide they're overcharging they can cancel.

 

[Winter_123]

Ok, let's play devil's advocate. What if Anthem was requesting a 65% increase stating that they expected to make a certain profit. Then what.

Nope. Not going to start from scratch on free market discussions.

I will only bring to your attention that it is not a free market situation here in Maine. It is already regulated and there are MLR requiresments that must be met in order to justify a rate increase. The MLR requirements when played out, go to your hypothetical of the 65%. Now, the state is saying, well frig that, we still think you are making too much because you made money out of state through Wellpoint etc and dont need a rate increase so frig whatever the ground rules were.

It is more than just a free market issue. It is an issue of complying but it is still never enough because the DOI believes it can implement new rules along the way as needed just based on how things are looking. Such is the socialist way. Believe me whatever rules Obama gets implemented, they know the right answer for the premiums and the profits and then they back the rules into them. So much for due process.

Coming to your neighborhood soon. Gonna leave it there for now.