Mass Decision Coming Right Up

[Winter_123]

Judge wants to move the case right along.

Implications for Maine, Obamacare and all the predictable stuff.

Of course Anthem is in court in Maine with the same issue.

What a mess either way. What a mess.

Judge vows quick decision in health insurance dispute - BostonHerald.com

 

[Crabcake Johnny]

It won't even be close; rate increases denied, motion to force the carriers to start accepting new business. Case closed.

 

[djs]

Not even close.
There cannot be a motion to force carriers to accept new business. There can be a judgement that if they choose to accept new business, they have to do it at the approved rates. They then can opt to not accept new business.

Is Mass a state that only requires rate change filings? Or do they have to be approved prior to implementation? I assume till now, only rate change notices had to be submitted, or else this would have been a non public issue. If this is true, then Mass is changing the rules in the middle of the game.

Dan
- - - - - - - - - - - - - - - - - -
Oops, answered my own question. The governor did some 'emergency' legislation in February (how convenient). While insurers are only required to file rate increases in Mass, the new 'emergency' legislation apparently did give the DOI some power to deny the increases.

Mass. insurance division limits proposed premium increases proposed by major health providers

Seems there are a lot of details conveniently left out on both sides of this story. What is not left out is the Governor is up for re-election and may be running against one of the former Presidents of one of the insurance companies he denied rate increases to.

Health Insurance - Meet political posturing. While this has always been true, it will get much more 'true' in the next few years.

Dan

 

[moonlightandmargaritas]

Seems there are a lot of details conveniently left out on both sides of this story. What is not left out is the Governor is up for re-election and may be running against one of the former Presidents of one of the insurance companies he denied rate increases to.

Not maybe running, he will be.

Actually, Charlie Baker (the leading Repub challenger, and a guy I went to high school with - he was a nerd - guess that's why he's running for Gov) was President of the Harvard Pilgrim HMO. The Mass health market is dominated by four "local" HMOs. They can't easily just "bail out" of the market without being out of business.

The two "non-domiciled" carriers (Aetna and Celtic) got the rate increase they requested.

Very little doubt that Deval Patrick's action was politically motivated.

 

[HealthGuy]

WTF is Celtic doing in MA? Third world carrier selling in the exchange? Analysis please.

 

[Winter_123]

Is Mass a state that only requires rate change filings? Or do they have to be approved prior to implementation? I assume till now, only rate change notices had to be submitted, or else this would have been a non public issue. If this is true, then Mass is changing the rules in the middle of the game.
Dan

The problem is that the states want to do price controls so are interpretting whatever the laws are on their books to try to achieve that.

Maine, for example, is a state where (for some) policies the state has to review and approve but must approve if the carrier can demonstrate that they are meeting the minimum required claims payout. Anthem did that, and the state agrees that they did but has just flat out decided that Anthem/Wellpoint is making enough money nationwide and can afford to go another year without an increase.

So there is a similar theme from state to state but different twists. The rulings all have major implications for MaoCare though. If increases are allowed then people are saying, WTF, I thought we were going to get some relief from all of this. And if increases are not allowed, then we plunge faster and more furiously toward the reality that nothing has been done at the state or fed level about cost controls so something has to give somewhere.

Yes, I know 2014 this and that. The people dont follow all these details. All they know is that the country was consumed by health care debate for over a year, so what the frig did we get out of it if my premiums are going up and I am told that my taxes are going up.

What a mess. There is no ruling in Maine or Mass in either direction that does not exacerbate the issue. It is a classic no win because the underlying problem has not been fixed.

Even though the judge in Mass is talking ballsy, he could also remand it to adminstrative hearings since the carrier did not exhaust their administrative remedies before going to court. That only buys the state six weeks though, and apparently the judge is willing to acknowledge that the situation is already at critical mass so is willing to cave on that issue a bit.

And of course, the feds are gunning bigtime for the authority to review and approve premiums so any failures to control at the state level are music to Obama's ears. Or, if the states just ignore their laws or rejigger them to implement price controls, then that is music to Obama's ears too because he is more than happy to take credit for it.

Also, in regard to "case closed." It will not be closed until it goes up through the appeals courts. This is true regardless of which side wins. Although, if the state loses (and the libs are still in charge in Mass, which they are) they may find it easier to just amend the law to whatever they want.

What a mess.

 

[CHUMPS FROM OXFORD]

Celtic does have some decent plans. They used to have decent rates. I remember selling a fair amount of their plans about 7-10 years ago.

 

[HealthGuy]

Celtic, decent? Come on Chumps

 

[somarco]

The DOI has the ability to levy fines, but those fines can be appealed. In the interim, there is no reason to expect the carriers to play ball if it means losing money by selling this years plans at last years rates.

Pay no attention to the elected official behind the curtain . . .

 

[moonlightandmargaritas]

Celtic does have some decent plans. They used to have decent rates. I remember selling a fair amount of their plans about 7-10 years ago.

Me too. They had an "any-doc-PPO" plan that was excellent.