Com­mis­sioner holds fo­rum on in­sur­ance woes

Sunday Star - - LOCAL - By DENAE SPIERING dspier­ing@ches­pub.com Fol­low me on Twit­ter @Dspier­ing617.

EAS­TON — In May, the Mar yland In­sur­ance Ad­min­is­tra­tion re­leased a state­ment with re­gard to health in­sur­ers re­quest­ing an in­crease of 50 to 90 per­cent in the in­di­vid­ual mar­ket.

The re­quest came from ma­jor health in­sur­ance car­ri­ers, in­clud­ing Care First Blue Choice Inc., Care First of Mary­land, Cigna and the Kaiser Foun­da­tion of the Mid-At­lantic. Care First, Cigna and Kaiser are the only in­di­vid­ual in­sur­ance op­tions through the Mary­land Health Con­nec­tion ex­change.

These in­creases will cost the av­er­age 40-year-old, non­smok­ing adult any­where from $359 a month with Kaiser to a $714 a month through Care First of Mary­land.

In a state­ment re­leased in May, the state of Mary­land In­sur­ance Com­mis­sioner Al Red­mer Jr. said these were merely re­quests.

“It is im­por­tant to re­mem­ber that these rates are what com­pa­nies have re­quested and not nec­es­sar­ily what will be ap­proved,” Red­mer said. “There will be a thor­ough re­view of all the fil­ings. As in years past, we may re­quire changes.”

To dis­cuss these changes and other in­sur­ance up­dates, Red­mer and his staff held an in­for­mal public meet­ing Wed­nes­day, Aug. 23, in the Ch­e­sa­peake Room of the Tal­bot County Com­mu­nity Cen­ter.

Red­mer said he holds these meet­ings semi­an­nu­ally and re­gion­ally to reach out to con­sumers, pro­duc­ers, busi­ness own­ers and in­sur­ance en­ti­ties.

“We have im­por­tant de­ci­sions to make, and too of­ten in gov­ern­ment or in any other big or­ga­ni­za­tion, folks get in that ivory tower and they never come out — not that we have an ivory tower,” Red­mer said. “But these meet­ings are very help­ful to us, to get out and talk to real peo­ple that are in this busi­ness ev­ery day. It helps us get a bet­ter un­der­stand­ing of what is go­ing on.”

He said there are ge­o­graph­i­cal is­sues that oc­cur, so it is im­por­tant to get out to other parts of the state.

“Thats why we come to Eas­ton, to Hager­stown, to Sal­is­bury. So we are able to get around to dif­fer­ent parts of the state,” Red­mer said. “The needs of one side of the state are not the same as other ar­eas.”

The all-day meet­ing was held in an open fo­rum style and bro­ken down into two parts.

The first was from 10 a.m. un­til noon, with only a dozen at­ten­dees. The agenda for the first meet­ing fo­cused on prop­erty and ca­su­alty in­sur­ance, dis­as­ter pre­pared­ness and up­dates from the Na­tional As­so­ci­a­tion of In­sur­ance Com­mis­sion­ers, in­clud­ing auto in­sur­ance and travel in­sur­ance.

The sec­ond meet­ing be­gan at 1 p.m., and drew a much larger crowd. More than 30 peo­ple at­tended to hear the com­mis­sioner’s stance and plans in ad­dress­ing life and the hot-but­ton health in­sur­ance mat­ters.

At­ten­dees for the sec­ond fo­rum in­cluded Sen. Ad­die Eck­hardt, R-37-Mid-Shore; Del. Johnny Mautz, R-37B Tal­bot; lo­cal in­sur­ance agents; in­sur­ance pro­ducer lob­by­ists; and men­tal health pro­fes­sion­als.

The health and life in­sur­ance meet­ing went over sev­eral top­ics: long-term care in­sur­ance, short-term med­i­cal in­sur­ance, cov­er­age gaps in Lym­phodema work­groups and phar­macy ben­e­fits.

The most dis­cussed topic was the Af­ford­able Care Act and its longevity, along with the re­quested in­crease in in­sur­ance rates.

Bob Mor­row, as­so­ciate com­mis­sioner for life and health for the state of Mary­land, led the dis­cus­sion on the Af­ford­able Care Act. He said Congress is out of ses­sion, but when it comes back in two weeks, it will have a lot to do in a short amount of time.

“What I can tell you is, in the in­di­vid­ual mar­ket, ev­ery­body is aware that we have seen the largest re­quested rate in­crease we have ever had,” Mor­row said. “This year, ob­vi­ously, it is a re­sult of a lot of things but pri­mar­ily losses in the in­di­vid­ual mar­ket.”

He said the in­di­vid­ual in­sur­ance mar­ket in Mary­land has not sta­bi­lized and the re­quested rate in­creases re­flect that.

“That pri­vate mar­ket is a huge prob­lem,” Mautz said. “A lot of peo­ple I talk to can­not af­ford to pay for the in­sur­ance they have now. The peo­ple I talk to are in their mid-50s, they live healthy life­styles, yet they are pay­ing more for health in­sur­ance than they are their mort­gage.”

Red­mer said the prob­lem is the dis­pro­por­tion­ally large amount of sick in­di­vid­u­als who are buy­ing the in­sur­ance plans ver­sus healthy in­di­vid­u­als who are opt­ing out of in­sur­ance plans al­to­gether.

“The sick are ring­ing the bell with med­i­cal ex­penses,” Red­mer said. “The prob­lem is not the size of the group. The prob­lem is, dis­pro­por­tion­ally, they are older and sicker. The is­sue is how do you get the price low enough to en­cour­age health­ier, younger folks back into the mar­ket.”

Red­mer said Care First re­ceived a 25 per­cent in­crease last year, and when that in­crease hit, con­sumers had to make a choice whether to “suck it up,” or drop in­sur­ance and go with­out cov­er­age.

Red­mer said in ad­di­tion to the rate in­crease re­quest this year, Care First is elim­i­nat­ing its point-of-ser vice plans in the in­di­vid­ual mar­ket.

“Those 26,000 peo­ple that were in that HMO plan, the point-of-ser vice op­tion will now have to make an elec­tion to a dif­fer­ent plan,” Mor­row said.

Mor­row said while the in­di­vid­ual mar­ket rate re­quests are high, the news for the small group mar­ket for em­ploy­ers and em­ploy­ees is a lot bet­ter, with rate re­quests peak­ing at 38 per­cent.

Red­mer said all the re­quested rate in­creases di­rectly re­flect the fail­ure of the ACA.

“You read about the term ‘death spi­ral,’” Red­mer said. “In my opin­ion, we are there.”

Red­mer said the prob­lem with the ACA is it is de­signed as one-size-fits-all around the coun­try. He said be­cause of that model, there is no flex­i­bil­ity on the state level.

“This puts us be­tween a rock and hard place,” Eckardt said. “We have to do some­thing be­fore we reach a tip­ping point, the point in which peo­ple stop par­tic­i­pat­ing all to­gether.”

“We are just about at that tip­ping point al­ready,” Red­mer said.

Mor­row said Care First con­ducted a re­cent pre­sen­ta­tion stat­ing what is driv­ing the cost is 13 per­cent of the peo­ple are ac­count­ing for 70 per­cent of the to­tal costs.

Red­mer said Mary­land is far­ing bet­ter than some states where there is no cov­er­age avail­able within cer­tain coun­ties.

“Un­for­tu­nately, at the state level, we can­not fix this,” Red­mer said. “The fed­eral gov­ern­ment, when they cre­ated the Af­ford­able Care Act, just about ever ything is done at the fed­eral level with very lit­tle flex­i­bil­ity.”

Red­mer said the more de­ci­sion mak­ing at the lo­cal level, the bet­ter.

“I would much rather have the Mary­land Gen­eral As­sem­bly mak­ing those de­ci­sions rather than the fed­eral gov­ern­ment,” Red­mer said.

For more in­for­ma­tion about the re­quested rate in­creases or other State of Mary­land in­sur­ance ques­tions, visit www.in­sur­ance.mar yland.gov.

PHO­TOS BY DENAE SPIERING

On Wed­nes­day, Aug. 23, in the Ch­e­sa­peake Room of the Tal­bot County Com­mu­nity Cen­ter, Mary­land State In­sur­ance Com­mis­sioner Al Red­mer Jr. and staff held a public dis­cus­sion of in­sur­ance changes and up­dates.

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