Insurance
by Politics What's more interesting than a rate hike in the individual
health-insurance market? Nothing, apparently, as both Democrats and Republicans
this week suddenly seemed fascinated by Anthem's request for a 20.5 percent increase
for its high-deductible
insurance product.
More precisely, they seem fascinated
by the opportunity to blame each other for its existence. The shame of this is
that none of them cared enough previously -- this would be the third year of double-digit
increases in this product -- to carry out Maine-based, detailed studies on why
the rate is rising so fast and how alternatives might affect it.
Democratic
House Speaker John Richardson says he intends to "ask tough questions"
about the increase. He's going to need a lot of information not available to the
public to do that. Anthem makes public aggregated numbers through what is known
as a Rule 945 filing, but it says dollar figures specific to its Healthchoice,
the individual insurance policies in
question, are proprietary.
Speaker
Richardson was reacting
to Republican gubernatorial candidate, state Sen.
Chandler Woodcock's complaint that the Baldacci administration hadn't done enough
to bring down health-care costs. But lawmakers don't actually know what the effect
of
the governor's reforms have been on Healthchoice -- no one's seen the numbers.
The
945 filings themselves are fairly new, having been instituted as part of Dirigo,
but they are insufficient to provide the proper level of detail. (Interestingly,
Anthem does report through the filing it was able to yield a small profit in 2005
on the Dirigo health individual plan, which has far lower deductibles than the
$5,000 to $15,000 deductibles in the private version and broader coverage.) Clearly
more extensive public filings are required if politicians are going to do more
than fulminate about this issue.
Anthem, for its part, is declaring that
it has hit a death spiral in the individual market -- a point at which rising
costs cause healthier people to switch away from the product, leaving sicker people
in the market, who cause costs to rise, etc. It wants a high-risk pool, something
Maine once had and abandoned, and its argument is that 1 percent of its individual
market, about 200 people, account for 40 percent of the cost. High-risk pools
make insurance affordable to the very ill through subsidies, either from taxpayers
or through a surcharge on health-insurance premiums. Several Maine Republicans
support this idea, though they oppose subsidized insurance through health-care
efficiencies in Dirigo.
Though Insurance Superintendent Al Iuppa predicted
a death spiral a couple of years ago, Anthem has yet
to demonstrate that
it is in one. The number of contracts it had for this market over the last five
years are as follows: 2001, 26,235; 2002, 28,192; 2003, 32,314; 2004, 35,461;
2005, 32,722. The company says utilization is way up but, again, is reluctant
to release numbers detailing that claim.
One aspect of Dirigo everyone seems
to agree on is the gathering of health-care data to produce better outcomes. The
political battle witnessed this week among many state lawmakers is, at one level,
an inevitable part of a campaign season, and, at another, a useless exercise when
the health of Maine's public is at stake. Transparency of costs, so these debates
can lead to effective reform rather than merely more argument, is the best response
to unaffordable prices.
