Rhetoric Heats Up Between Insurers And Lawmakers
Politico: "Sen. Jay Rockefeller (D-W. Va.) is scolding the nations' health insurance companies for 'gaming' the new health care law and is pushing the administration and states to impose stringent controls under the law on industry expenditures for non-medical purposes. Saying the industry had turned its focus from opposing the law to influencing its implementation, Rockefeller said he was 'extremely concerned that the health insurance industry is mounting an all-out effort to weaken' the law" (Kliff, 5/9).
Reuters: "Rockefeller, in letters to the U.S. health secretary and a state insurance group, said insurers are seeking to undermine new reforms governing how much insurers spend on medical care versus other costs, known as medical loss ratios (MLRs), and that the Obama administration and state insurance group should be skeptical of any industry proposals. The Obama administration is working to implement the law, which calls for 85 cents of every premium dollar in large group health plans to be spent on actual medical care rather than administrative costs. For small group and individual health plans, 80 cents of every dollar must cover medical care." An investigation by congressional committee staff found that many insurers meet the new standards, but not in all markets or for all plans (Heavey, 5/10).
Dow Jones Newswires/Wall Street Journal: "An NAIC panel plans to meet Monday afternoon to discuss draft responses to questions the Department of Health and Human Services published regarding implementation of the MLR requirements. The NAIC aims to have its response to HHS Secretary Kathleen Sebelius by June 1, at her request, as the new requirements start going into effect in late September"(Wisenberg Brin, 5/10).
Los Angeles Times: Meanwhile, "[a] war of words between President Obama and health insurers escalated Sunday as industry giant WellPoint Inc. found itself under renewed attack for raising rates and canceling insurance policies of sick patients. President Obama raised the issues as part of his weekly radio address. ... WellPoint Chief Executive Angela Braly fired back. In a letter Sunday addressed directly to Obama, she noted that policy changes were underway nationwide, and she called on him to stop his attacks on the industry" (Helfand, 5/10).
Politico, in a separate story: "WellPoint came under criticism in late April after a Reuter's investigation accused he company of targeting breast cancer patients for fraud investigations with the intent of cutting off their insurance" allegations the company denies. In her letter to Obama, "Braly laid into Obama's willingness to criticize the insurance industry, especially in light of their role in implementing the administration's law" (Kliff, 5/10).
The Wall Street Journal's Health Blog: "WellPoint has also been taking heat for miscalculations in its requested rate increases in California. Last week Sebelius urged other states to also check the insurer's math for errors. Obama said in his address that his administration has established a new Office of Consumer Information and Insurance Oversight to help make sure insurers don't game the system. Braly's letter called for an end to the Obama administration's 'attacks on the health insurance industry' and said the insurer wants to have a sit-down with Sebelius - an invitation Braly says has so far gone unanswered" (Hobson, 5/10).
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