i Citizens pan Anthem rate increase
Citizens pan Anthem rate increase
BY SUSAN M. COVER
Staff Writer Kennebec Journal & Morning Sentinel 03/13/2009

GARDINER -- Jean Chaude, of Belgrade, paid $243 a month for her health insurance in 2005 -- an amount that could grow to $458 a month if a new rate increase is approved by state regulators.

She said she can't afford it, and neither can many Maine families.

"How much profit, how much surplus is enough when the dignity and well-being of the insured is in danger?" she asked.

Chaude was one of more than 50 people who packed a hearing room Thursday at the state Department of Professional and Financial Regulation for a public hearing on proposed increases in premiums for some Anthem Blue Cross/Blue Shield products.

The company is asking the state to approve increases in its HealthChoice, HealthChoice Standard and Lumenos Consumer Directed Health Plan products, according to the state Bureau of Insurance.

The average increase is 18 percent. More than 12,000 policyholders would be affected.

Thursday's public hearing was the third and final chance for the public to give feedback to the state about the proposed rate hike.

Insurance Superintendent Mila Kofman said she must determine whether the requested increase is "excessive" or "discriminatory," whether the coverage is adequate and whether the company meets codes and regulations.

Kofman and others from the state -- including the Office of the Attorney General -- heard testimony from several people frustrated by their health insurance.

Not all of the venom was directed at Anthem, but many questioned the company's profits and the pay of top executives.

Anthem reported $51 million in profit last year, according to a report on file with the state, but showed only modest gains in covering individuals, Anthem spokesman Christopher Dugan said.

Dugan said products offered to those in the individual market made only 3 percent profit and that 90 cents of every health care premium dollar went toward paying claims.

"The reason for the rate increase is we need to have enough money in the pool to cover claims going forward," he said. State regulations that prevent the creation of a high-risk pool, and escalating health care costs nationwide, also contribute to the problem, he said.

But retired lawyer Peter Beckerman, of Sidney, who said he has a policy with a $15,000 deductible, called the proposed increase "outrageous" and said the state Bureau of Insurance should investigate Anthem's finances.

"This rate increase is just one more nail in the coffin for retirees," he said. "Don't be taken in by outrageous requests for increases and ... allow them to laugh all the way to the bank."

Robert Sezak, of Fairfield, who owns a used bookstore in Waterville, said another increase may make him drop coverage.

"I am faced with abandoning health insurance, as is my life partner," he said.

Frank Giordano, of Newport, said that while the average increase may be 18 percent, he's looking at a 37 percent increase in the premiums for him and his wife.

They each pay $328 a month now, he said, but their cost would increase to $448 if the increase is approved.

He said when his wife paid for a mammogram out of pocket, it cost $150. The next time, when the cost was picked up by insurance, the hospital charged $375.

"If they are going to overpay they hospital, they might as well cut our premiums," he said. "Why should they pay two and a half times what I would pay at the hospital?"

Kofman will have 30 days from the time she ends the public comment period to render a decision.

Although that date is uncertain, Anthem wants to put the new rates into effect July 1.

Her decision can be appealed to Superior Court.

Eunice Spooner, of Sidney, who is quadriplegic, spoke on behalf of her caregivers, who cannot afford health insurance.

"It is wrong that caring people who help me to live a fulfilling life can't enjoy the health care they deserve," she said. "Anthem is making a large profit. Why can't they give us a break?"

Susan Cover -- 620-7015

scover@centralmaine.com

Bookmark and share this story: digg del.icio.us Reddit

Reader comments

Click here to view or add reader comments