Blue Shield of California defies state insurance commissioner over rate hikes

[cal04]

Source: Los Angeles Times

Defying California’s new insurance commissioner, Blue Shield of California has refused to delay controversial health insurance rate hikes for 60 days that prompted an uproar among customers who are seeing successive increases over the last five months of up to 59%.

The nonprofit San Francisco-based insurer said it would submit its latest increase -- effective March 1 and averaging 15% -- for review by an outside expert. It pledged to issue refunds to customers if errors are found in its paperwork.

Insurance Commissioner Dave Jones immediately condemned Blue Shield’s move, saying the company acted on its own without consulting him. Jones discounted Blue Shield's characterization of its action as “unprecedented,” noting that a new state law requires all insurance rate hikes to undergo scrutiny by outside actuaries.

Jones, however, has limited authority to stop rate increases. He can only do so in cases where an insurer spends less than 70% of premium income on healthcare expenses.




Read more: http://latimesblogs.latimes.com/money_co/2011/01/blue-shield-of-california-defies-state-insurance-commissioner-on-rate-hikes.html

[Fumesucker]

1. We have just been shown the future of Health Insurance Reform..

The insurance companies will do as they wish and ineffectual regulators will be left in the dust of their incredible rate hikes.

[jody]

5. Are there laws that prevent new, innovative insurance companies from competing with the few

insurance companies who use their lobbyist and campaign donations to absolutely prohibit small health insurance with innovative ideas from offering cost-effective alternatives to the corporate state?

[eridani]

18. Laws don't prohibit it--small risk pools do

One major illness in a small risk pool destroys the small insurance company. And now Vanna, tell our contestants what they might win if they can name the biggest and therefore cheapest risk pool of all?

[glinda]

17. Insurance Cmpanies. Banks, big Pharma, big oil, big media, NRA, Chamber... all of them!

We can include their puppets on the Right in that also. They are taking over and they do not care.

[jody]

2. Interesting development, either govt aka dictator decrees prices or individuals decide what a

product/service is worth.

Russia and China experimented with govt controlled prices as has New York City controlling rent.

We talk about "lessons learned" but what about "failures ignored"?

[eridani]

19. France, Germany and Japan have government dicated health care and insurance costs

They provide care for their populations at half the price per capita that we spend. The German experiment has been working since the 1890s.

[progressivebydesign]

3. the first thing I'd do is remove their "non-profit" status.

total BS. If they were truly non-profit, their CEO and such would be making 100k a year. That's a sham.

[sarcasmo]

4. The health care system is only going to get worse, imho.

[jody]

7. Agree, that's a symptom of movement of a free sovereign people who created a govt. to

represent them, into a corporate state which was the ultimate goal of Stalin's communism and Hitler's fascism.

Where are the leaders who will lead us back toward a "government of the people, by the people, for the people" and away from the path to serfdom offered by a corporate state?

[girl gone mad]

14. Wall Street has its eyes on the prize of health care dollars.

They are set to move in to this market in a big way, with the new mandate guaranteeing capital flows rich enough to suit their exploitative demands.

[Thav]

15. I only partially agree

The providers of health care will continue to provide the best care they can. Our local facility has done great things. However, payment and authorization of procedures will continue to hinder these providers from giving the best care. Also, as facility executives find new, "innovative" ways to cut costs and raise profits the only people who will be getting health care are those who can truly afford it.

In a country where, even with insurance, a visit to the hospital has the possibility of putting you into bankruptcy... there's something wrong there.

I think when people are treated like people, rather than profit centers, is when the system will truly turn around.

[Plucketeer]

6. Truly disgusting

THIS is the kidna shit we wouldn't have to swallow if we'd had a PUBLIC OPTION passed. THANK YOU Mr. President.





Psssst... Hey kid! Wanna buy some
health insurance?

[jody]

8. On behalf of all corporatists who wish to enslave We the People, "THANK YOU Mr. President". n/t

[Puzzledtraveller]

16. what I'm seeing

The portion I pay for my insurance doubled this last open enrollment and I had to take a really crappy plan to come close to the same out of pocket had a year ago. I work for a state doing eligibility for family medicaid and we have had a lot of people come in who are dropping their children off their health plans from their work because they cant afford the rates for families. In my state you can be eligible for health insurance for children under 19 even if you have or are offered health insurance from your employer and we have had a huge increase in applications.

[Journeyman]

9. Hmm - doesn't seem quite the "change" I'd hoped for. . .

at this rate, I'll be "reformed" right out of health care coverage some years before the "exchange" kicks in (though I fear it, too, may serve only to screw me).

Twenty-percent rate increases. Every year for the past 12 years. That's what my wife and I have had to contend with since we started our business.

[Sherman A1]

10. The commissioner may have limited powers in this case

as stated in the OP, however I would be willing to bet if he showed up with a team of auditors on Monday Morning at the HQ of Blue Shield, he might make an impact on their day.


Something along the line of "Okay have it your way.... This group of CPA's is just going to audit every piece of paper and computer file in the building."

"And as always..... Have a nice day....."

[SoCalNative]

12. He'd have to wait until Tuesday

Monday's a holiday!

[ProgressiveProfessor]

13. He would not get passed the lobby

The rules are well understood by both sides and the insurance commissioner is an elected office and the incumbent a pol. Based on what he is doing, it means that he does not have an effective way to stop this.

[davidinalameda]

11. anyone want to call them

You can call us at [phone], Monday – Thursday 8 a.m. – 5 p.m. PST, Friday 9 a.m. – 5 p.m. PST. Please note, however, that we may have to forward your call in order to serve you best.