Protecting Patients
Workers at a Portland, Ore., steel mill soon will be able to pick a new
type of insurance that offers free care for some illnesses, such as
diabetes or depression, but requires hefty extra fees for treatments
deemed overused, including knee replacements, hysterectomies and heart
bypass surgery. The policies are among the first to apply financial incentives on both
sides of one important factor driving up the nation's health care tab:
The underuse of proven treatments and overuse of certain surgeries and
diagnostic tests that may be less valuable. But efforts to charge workers more for some treatments put employers in
the position of "playing doctor" and are well into a "danger zone of...
limiting access to medical care," says Jerry Flanagan of the Santa
Monica, Calif.-based advocacy group Consumer Watchdog.
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President Obama should include a provision freezing health insurance
rates in the package of revisions Democrats are drafting for the
Senate-passed health care overhaul bill (HR 3590), a California-based
consumer group said Wednesday. Other provisions that the Consumer Watchdog group wants to see included
are a requirement that state regulators approve rate increases before
they go into effect, and that federal grants be made available to
states for developing these "prior approval" regulations. "Given the audacity of health insurance rate increases last year and
this year, and with the economy in deep recession, only federal
legislation can curb the spiral of unaffordability," said Carmen
Balber, the Washington director for the group.
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LOS ANGELES, CA (AP) ― State insurance regulators on Wednesday defended their actions against health insurers after a report showed few consumers who complained that their coverage was canceled after they took ill actually benefited from state-negotiated settlements. The settlements may not have appealed to many consumers because they
were "very stilted towards insurance companies," said Jerry Flanagan, a
health advocate for Consumer Watchdog. Consumers weren't allowed to hire lawyers for arbitration, and had to
prove all their past medical bills were "medically necessary, which is
a hard legal standard to meet" without a lawyer's help. Additionally, the coverage that was offered through arbitration was
usually a policy with a lower benefit than the wrongfully rescinded
policy, said Flanagan.
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California's Consumer Watchdog group is suing Anthem Blue Cross after
they raised health care insurance premiums 39 percent, but the company
isn't budging. Meanwhile Goldman Sachs recommended buying health insurance company
stock because competition is decreasing and prices are going up. The
Center for Retirement Research at Boston College estimates that "the
typical married couple at age 65 should expect to spend" a whopping
$197,000 on uninsured medical expenses. Obama urges action on a
watered-down health care bill, but the Republicans and conservative
Democrats just say no and collect money from the private health care
lobby. Will we continue to tolerate skyrocketing health care costs?
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Washington, DC -- Harvey Rosenfield, author of California’s landmark
insurance regulation Proposition 103—recognized as the most successful
insurance regulation in the country—was joined today by people
struggling to pay for health insurance in calling on President Obama
and Congress to impose a national freeze on health insurance rates as
part of the final round of votes on reform. Consumers must have a
breather from yearly premium hikes like the 39% increase planned by
Anthem Blue Cross, said Consumer Watchdog, which Rosenfield founded.
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Insurers Would Get Tens of Millions of New Customers Under
Reform, and Owe Americans a Break from Audacious Rate Spikes By Anthem
Blue Cross and Others
Washington, DC -- Consumer Watchdog called on President Obama to impose
a national freeze on health insurance rates before health reform takes
effect to protect consumers from premium hikes like the 39% increase
recently announced by Anthem Blue Cross in California. The rate freeze
is one of five tools Consumer Watchdog urged the president to include
as part of his proposed fixes to the Senate health care bill.
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There have been demands for explanations from state and federal
lawmakers as well as the White House. Documents of financial records
have been subpoenaed. Last week, Consumer Watchdog filed a lawsuit in
Ventura County Superior Court alleging the insurer doesn’t offer
adequate alternatives when it closes a policy.
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A consumer group has filed a class-action lawsuit against Anthem Blue
Cross of California, alleging the company's strategy in deploying an
average 25% rate increase for individual plan customers violates state
law. The lawsuit was filed by Consumer Watchdog on behalf of two Anthem
policyholders who are covered under a program the insurer closed to new
enrollees on Sept. 25, 2009. This triggers a "death spiral" as rate
increases fall to "those remaining in the closed book of business until
they can no longer afford coverage," the lawsuit stated.
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The company used controversial rate hikes, as high as 39 percent, to
force older and sicker customers into high-deductible plans with fewer
benefits so it could save money, Santa Monica-based Consumer Watchdog
alleged in the complaint. The lawsuit seeks to end that tactic of "closing" an insurance product
and raising rates to members while offering them cheaper plans, which
plaintiffs say is known in the industry as the "death spiral."
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On Monday, Consumer Watchdog filed a lawsuit seeking class-action
status against Anthem Blue Cross, alleging that the insurer is forcing
subscribers into a coverage "death spiral." The suit, filed in Ventura
Superior Court, accuses Blue Cross of hiking premiums to force
subscribers from benefit-rich policies to less expensive coverage with
fewer benefits and higher deductibles. The scrutiny has been welcomed by many, including consumer health care advocacy groups.
Read more »
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Recent Articles:
Insurers Test Health Plans That Stress Patient Choices
By Julie Appleby, USA TODAY
March 11, 2010
Read More »
California Group Urges National Freeze On Health Insurance Rates
By John Reichard, CONGRESSIONAL QUARTERLY HEALTHBEAT
March 10, 2010
Read More »
Calif. Regulators Defend Dropped Insurance Deals
By Shaya Tayefe Mohajer, ASSOCIATED PRESS
March 10, 2010
Read More »
Profiting From Collusion: Why Californians Can't Afford Health Insurance
By Don Monkerud, COUNTERPUNCH.ORG
March 10, 2010
Read More »
Insurance Regulation Expert Calls For Freeze Of Health Rates Until 'Prior Approval' Regulation Is Adopted
CONTACT: Jerry Flanagan, (310) 889-4912; or Carmen Balber, (202) 629-3043
March 10, 2010
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