Anthem (continued) The Real Fight Begins

[Winter_123]

The Anthem situation in Maine has been discussed but we are just a small state so it does not rock the boat. California does.

To me, this is the beginning of one of the real fights in health reform. Down below the slogan level. Rate increases were denied in Maine and Anthem has bitten off a real dogfight in CA but how can it be avoided assuming they want to stand by their data. I have no way of knowing what their supporting data looks like but it is a given that at some point rising costs must translate into rising premiums. This is true even if a rate increase is inflated. It might buy you a year or two to fend off rate increases and maybe a carrier can live with them if they are fluffed up a little, but sooner or later reality sets in or else you are subsidizing someone. Other states are already subsidizing Maine because the DOI denied an increase saying that Wellpoint just didnt need any more money because they were making so much nationwide.

It is not the only "real fight" but it is certainly one of them. Example, one level of the fight is to see where and when GI gets passed, but then the next level of the fight is to see what happens when we see what it does to premiums. It is one thing to talk and act fluffy. Tis another to deal with the fallout.

Both Obama and Hillary said that under their administration they would simply tell the carriers what the premiums will be. Okay fine, tell Anthem what the premiums are going to be and lets get on with it.

Obama Administration Blasts Anthem Blue Cross Rate Hikes - Political Hotsheet - CBS News

 

[sman]

No worries. The California Senate just approved a single payer health system. Of course, it has to make it past the Assembly and governor and the same measure has been vetoed before. But the winds of change are blowing in California and the governator won't be there much longer to veto these types of measures.

How out of touch with reality are California politicians? Their state is beyond broke and they are proposing more expenses to the taxpayers there. Absolutely amazing.

While I understand the frustrations of these rate increases, the free market should allow for many of those 800,000 to find coverage elsewhere. Is Anthem the only carrier in California?

In running a quick quote comparison on ehealth for 90755, it appears that Anthem is far less expensive than it's competitors. So does this rate increase put them more in line with their competitors? I don't know. Maybe someone like Rick can share some insight on the California landscape.

The Anthem situation in Maine has been discussed but we are just a small state so it does not rock the boat. California does.

To me, this is the beginning of one of the real fights in health reform. Down below the slogan level. Rate increases were denied in Maine and Anthem has bitten off a real dogfight in CA but how can it be avoided assuming they want to stand by their data. I have no way of knowing what their supporting data looks like but it is a given that at some point rising costs must translate into rising premiums. This is true even if a rate increase is inflated. It might buy you a year or two to fend off rate increases and maybe a carrier can live with them if they are fluffed up a little, but sooner or later reality sets in or else you are subsidizing someone. Other states are already subsidizing Maine because the DOI denied an increase saying that Wellpoint just didnt need any more money because they were making so much nationwide.

It is not the only "real fight" but it is certainly one of them. Example, one level of the fight is to see where and when GI gets passed, but then the next level of the fight is to see what happens when we see what it does to premiums. It is one thing to talk and act fluffy. Tis another to deal with the fallout.

Both Obama and Hillary said that under their administration they would simply tell the carriers what the premiums will be. Okay fine, tell Anthem what the premiums are going to be and lets get on with it.

Obama Administration Blasts Anthem Blue Cross Rate Hikes - Political Hotsheet - CBS News

 

[somarco]

comparison on ehealth for 90755, it appears that Anthem is far less expensive than it's competitors.

If Sebelius and Obama get their way they will be denied the rate increase, which will make them even more competitive, leading to market domination. Of course when one carrier dominates the market it becomes obvious to the folks in Washington there is not enough competition.

 

[GreenSky]

I just ran a price for a prospect currently with an Anthem copay plan. She has a $5K deductible and $7.5K out of pocket.

I suggested she try and transfer to a $5K HSA plan. She's 48 and the premium is $135 - after March 1. That's more than affordable.

When people (and insurance carriers) shift their focus to protecting people from catastrophic claims, prices will go down.

However, when Dave gets here, I suspect he'll have a different take. Here's his latest blog post (and as usual, it's brilliant):

California Health Insurance Blog - by David Fluker: Is The California Individual & Family Health Insurance Market In Critical Condition?

Rick

 

[Dave020]

I believe that Kaiser Permanente will gain market share to the degree of their so-so IFP underwriting. All of the other carriers are going to strip out plans to evenually end up with HSA and Cat plans. Kaiser has an advantage with cost controls that no private insurance carrier has. NFR is one thing, actually owning the means of delivery is way better when it comes to cost control. Kaiser P may be the "last man standing" for co-pay preventive care at an affordable premium (others can do it on HMO, but the costs are escalating rapidly).

I just heard on KGO this evening (Anthem BC CA is getting a lot of national bad press right now) that according to the author of the LA Times article, overall health care costs over the last year have risen 5.7% (does that justify a 39% rate increase?).

Aside from this rate action (which is fugly) take a close look at the benefit changes 3/1 on the Anthem BC CA IFP plans. A couple that caught my eye were co-insurance change on maternity on HMO from 0% to 20%. SmartSense is killing the 4th quarter deductible carryover (a major selling point for that plan). There are a lot more changes, all of them ugly (Rx and so on).

The only time HSA plans make me nervous is when I am dealing with someone who either won't fund the account or someone who simply cannot afford to fund it, even with the lower premium.

HSA plans are a little like the BTID in health insurance. Lower premiums increase savings to the subscriber and create an incentive to be careful in non-catastrophic utilization. In practice it works best either in employer-sponsored plans (where there is employer contribution, like Whole Foods) or with people in IFP who have the means to absorb the costs under the deductible first (funded HSA or not). They need to invest some or all of the premium savings into the HSA account to get the tax advantages and have the $ to pay the doctor. But, just like BTID, not everyone will save any of the savings.

I spend a lot of time, especially when dealing with HIPAA, explaining the mental shift that needs to occur when coming off of group coverage. I explain it thusly:

Employer-sponsored group plans and individual health plans are not comparable on an apples-to-apples basis. Group plans generally offer a much richer level of benefits and cover benefits that IFP does not (or at least does not very well).

Individual & family plans are designed primarily as catastrophic coverage to keep you from going bankrupt. Group plans are used as an employee attraction and retention tool. They must be very competitive to attract and retain quality employees, just like the 401(k) and other benefits in the package. A 401(k) matched to 10% is far more attractive than a self-funded IRA. Same with health insurance.

 

[CHUMPS FROM OXFORD]

My Anthem rate went up more than 30% and I'm thinking of changing carriers.

 

[AffordableLife]

Maybe someone can help answer a question for me. I have been only doing life and medicare the last 3 years, so I don't know much about health insurance.

My Anthem policy has gone up $220 a month. I would like to switch, but I do have some health issues. Would there be any company that would take me?

Anthem said I would need to go thru underwriting to get a lower cost policy.

 

[Dave020]

Maybe someone can help answer a question for me. I have been only doing life and medicare the last 3 years, so I don't know much about health insurance.

My Anthem policy has gone up $220 a month. I would like to switch, but I do have some health issues. Would there be any company that would take me?

Anthem said I would need to go thru underwriting to get a lower cost policy.

Some plan changes do require underwriting, some do not. It depends on which plan you are on. If you want to PM me with your current plan I can check the 3/1 matrix to see what if any plan choices you may have without underwriting.

 

[dgoldenz]

Anthem rates up 21.5% in VA for co-pay plan, 12.5% for HSA....HSA still priced way below the rest of the market.

 

[AffordableLife]

Thanks Dave,

I have already check with them and can only change to one plan. I currently have the select HMO and can only go to a PPO it is about $200 less but I would wind up paying more with the deductables.