Anthem customers protest proposed rate increases

Posted March 14, 2011, at 9:07 p.m.

ORONO, Maine — Only a handful of people showed up Monday evening to comment publicly on the latest bid by Maine’s largest health insurance company to raise its monthly premium charges. But not one of them had anything nice to say about the company, Anthem Blue Cross and Blue Shield of Maine.

“We all know this is not about delivering quality health care,” said irate Mapleton resident Shelly Mountain. Speaking at a public session hosted by the Maine Bureau of Insurance and its superintendent, Mila Kofman,  Mountain said Anthem instead is focused on paying disproportionately high executive salaries and satisfying its Wall Street investors as monthly premiums like hers rise inexorably, year after year.

Anthem submitted the proposed rate increases in February for nongroup policies held by individuals and sole-proprietors. About 11, 000 Mainers now are covered by the affected  Anthem plans, which could go up by an average of 10 percent if the proposal is approved.  Some plans would increase by as much as 19 percent.

Kofman is charged with determining the overall impact of the proposed increases, including ensuring that they are not “excessive, inadequate, or unfairly discriminatory” according to state regulations. If approved the new rates would take effect July 1.

The company says the increases are necessary to maintain even marginal profitability in the individual portion of its business, where health care costs rise as enrollments shrink. But consumers argue the company holds an effective monopoly in the individual market and is gouging struggling Mainers who have no alternative than to pay up or go without.

Mountain says she now pays $516 a month for a coverage plan with a $15,000 annual deductible. The cost would go up to $570 a month — about $6,800 a year — if Anthem’s sought-after rate increase is approved. For what she pays, she alleged at the hearing, she can’t even get a straight answer from the company’s customer service department, much less anything as useful as nutritional information or other advice  to help manage her husband’s diabetes in the absence of medical appointments the couple can’t afford to keep.

Others speaking at the hearing did not mince words either.

“If this rate increase goes forward, we’re going to have to drop our insurance,” said Jackson farmer David McDaniel, who in 2008 left a career in health care administration to farm organically. His wife, Heather Selin, is self-employed as a health care consultant. The couple’s policy, which comes with a $15,000 deductible for each of them, has risen in price from $540 a month in 2008 to $726 a month in 2010. Short of a catastrophic illness or injury, said Selin, all it covers it one preventive visit apiece per year.

“When you’re trying to start out and be self-employed. you can’t afford this,” McDaniel said.

Sole-proprietor Nathan Freeman of Bangor, who hand-crafts violins, violas and cellos in his Central Street workshop, said he held off from purchasing meaningful coverage for years because of the exorbitant cost. But after a bout with potentially fatal melanoma and unrelated injuries suffered in a car accident, he recently invested in a $2,500-deductible Anthem plan. Within six months, he said, his premium increased from $670 a month to $760 a month and is now slated to go up again.

“Right now, it’s an amazing amount I’m paying out, ” he said. “There will come a point when it is not just a burden but simply impossible.”

Freeman said sole-proprietors and individuals are being discriminated against and questioned why Mainers who don’t qualify for employer-subsidized group coverage can’t form groups of their own to negotiate lower prices with insurance companies.

All told, just eight people offered testimony at the hearing, which featured representatives of the insurance bureau as well as from the Maine Office of the Attorney General, the nonprofit Consumers for Affordable Health Care and Anthem.  The low turnout may have been because of a bureaucratic delay in sending out notices to Anthem policyholders warning them of the impending rate increase, said Greg White of Consumers for Affordable Health Care. It was unclear at the hearing when the notices were mailed out, but White said all policyholders should receive them shortly. “We hope the turnout in Portland will be stronger,” he said.

The session, held Monday evening at the University of Maine in Orono, was the first of three public comment  opportunities scheduled in advance of a formal evidentiary hearing slated for Wednesday, April 12, in Gardiner. The next public comment session will take place from 5 to 7 p.m. Tuesday, March 22, in the Wishcamper Center at the University of Southern Maine. The third session will take place from 4 to 6 p.m. Monday, April 11, at the Department of Professional and Financial Regulation offices on Northern Avenue in Gardiner.

More information about Anthem’s rate request is available at the website of the Maine Bureau of Insurance,  http://www.maine.gov/pfr/insurance/

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