Anthem clients protest Proposed rate hikes anger policyholders

AUGUSTA – Those who buy their own individual health insurance say they already face a herculean task paying the monthly premiums. Now they’re worrying that proposed increases by insurance giant Anthem Blue Cross and Blue Shield will crush them.

Several Anthem policyholders told Superintendent of Insurance Alessandro Iuppa on Wednesday that Anthem’s average proposed increases of nearly 14 percent on HealthChoice products and nearly 32 percent on individual HMO products are excessive.

“As it is now the $551 [per month] is just about breaking me,” said Wendall Fletcher at the public hearing in Gardiner.

The Portland man said his premiums would jump to $628 if the increases were approved. He noted that he doesn’t charge the tenants in his two rental properties more than they can afford even though he could itemize expenses to justify such an increase.

For more than an hour, policyholders explained their problems to Iuppa. He explained that he understands the dilemma they face when dealing with high insurance premiums. He also said he had received many letters and e-mails on the proposed hikes that he will consider.

Iuppa will decide whether the requests are excessive, inadequate or unfairly discriminatory before issuing a decision within 30 days. The hikes would take effect Jan. 1.

Anthem has 26,000 Mainers enrolled in its individual insurance products, and it dominates the health insurance marketplace in Maine. Representatives say the increases reflect growing use of medical services and higher charges for those services.

“The applicants are proud of the fact they continue to provide nongroup coverage in a marketplace where others have fled,” said Christopher Roach, an attorney for Anthem.

Roach said Anthem is sympathetic to the plight of Mainers facing high individual health insurance costs that aren’t unique to Maine. But he said Anthem’s proposed increases in Maine are reasonable.

Most of the highly technical discussions about whether Anthem’s financial reasoning is sound was held behind closed doors Wednesday at Anthem’s request.

“It’s my recollection that confidentiality was asserted for just about everything [by Anthem], including the submittal letter,” Iuppa said.

The Attorney General’s Office and Consumers for Affordable Health Care intervened in the proceedings. Assistant Attorney General Christina Moylan said Wednesday that her office had not yet decided whether to oppose the increases, although it has many questions.

The attorney general’s witness, Paul T. Swoboda, an Arlington, Mass.-based consultant, said in prefiled testimony that Anthem’s proposed price hikes are not justified and are excessive. Sections of the testimony were kept from public view in order to keep financial details private.

Roach said Wednesday that Swoboda’s analysis was flawed.

During the hearing some said that regardless of whether the rates are approved, plans must be developed to help people afford insurance.

Fletcher, the policyholder from Portland, proposed a tax on unhealthful food to assist in the purchase of individual health insurance.

John Moran of the Maine Council of Senior Citizens accused Anthem of being a greedy corporation and asked the Legislature to develop a program of health insurance for individuals based on Medicaid.

One similar proposal was made to the Legislature last year by House Speaker Michael Saxl. It sought to allow individuals to buy into the state’s Medicaid program. Gov. Angus King opposed the idea and prevailed in having it removed from a bill late in the session.

During the legislative session, King directed Iuppa to propose an insurance overhaul that would have relaxed mandates requiring insurers to create standard policies that ensure certain medical services are covered. The proposal also would have given Anthem and other insurers more latitude in charging more for coverage of the old and sick than for the young and healthy. That measure was defeated by legislators.

During questioning Wednesday, Iuppa asked several Anthem policyholders if they would support fewer mandates, to which they said they would.

At the same time, Joseph Ditre, executive director of Consumers for Affordable Healthcare, also asked several if they would support Saxl’s idea, and they said they would.

Policyholders said that until there are changes, they face dire choices when health insurance is a budget item as large or larger than taxes.

“This is not a rhetorical question,” said Sharon Osborne, an Anthem policyholder from Union. “What do you do?

“This is about pain and fear,” she said.

“I don’t want anyone leaving this room thinking I don’t think this is a highly personal matter,” Iuppa said. He said that in the last few years questions about insurance matters have turned into questions about financing health care.

“I recognize it’s an emotional issue,” Iuppa said.

“It’s a life-and-death issue for a lot of people,” Osborne replied.