health insurance

Don't Weaken PA's Oversight of Health Insurance Rate Hikes

Many states have taken steps to ensure that there is a meaningful review of proposed health insurance rate increases for small businesses and individuals.

Pennsylvania, however, is headed in the opposite direction with legislation in the House and Senate that would keep more consumers in the dark and undermine the state’s ability to review most rate hikes.

House Bill 1983 and Senate Bill 1336 would extend rate review to insurance providers that currently escape any scrutiny, but they also reduce the Insurance Department’s authority to review and disapprove rates. The bill would give insurers license to raise individual and small business rates by 9.99% annually without any review at all. Small employers already struggling from the recession cannot afford continual rate increases and deserve to have better protection than this bill affords.

You can get more details in a memo that Pennsylvania Budget and Policy Center Director Sharon Ward wrote to editors and reporters today.

Under current state law, the Pennsylvania Insurance Department has some authority to review rate increases. It is not a perfect system, but the Department has used it effectively to perform rigorous reviews of numerous rate proposals. According to a recent Government Accounting Office study, in 2010, 37% of rate filings were reduced or withdrawn after Insurance Department review, ranking Pennsylvania 9th in the nation.

Instead of curtailing the Department’s authority, lawmakers should improve upon it with greater transparency, citizen input and meaningful review of all rate proposals.

Building a Competitive Insurance Marketplace in PA

A blog post from Christopher Lilienthal, originally published on Third and State.

So have you ever used Travelocity to book a flight? Or the Consumer Reports web site to research a new car?

Then you probably know the value of comparative shopping. I, for one, never book a flight before comparing just about every option and airline. What is the cheapest day of the week to fly, which airline offers nonstop flights, how long will I be in the air?

As Antoinette Kraus of the Pennsylvania Health Access Network (PHAN) wrote in an op-ed last week:

Sites like Travelocity have made air travel, car rentals and hotel bookings more convenient, competitive and affordable.

The same can't be said for health insurance, but that's about to change. The federal Affordable Care Act calls for the creation of competitive health-insurance marketplaces by 2014 to provide individuals and small businesses with a place to buy high-quality, affordable health coverage.

Pennsylvania's Insurance Commissioner is holding hearings this month to gather public input on what the state's new health insurance marketplace should look like. Hearings were held outside Pittsburgh and Philadelphia earlier this month, with the third and final hearing happening today near Harrisburg. Sharon Ward of the Pennsylvania Budget and Policy Center will be one of the testifiers at that hearing.

AdultBasic Sings the Blues

Last week, advocates across Pennsylvania called on state lawmakers to preserve the adultBasic health insurance program.

AdultBasic provides affordable, no frills health coverage to adults earning up to 200% of the Federal Poverty Level. Before last week's statewide Day of Action, organized by the Pennsylvania Health Access Network (PHAN), few people were aware that the program is in jeopardy.

But it is, as PHAN and the Pennsylvania Budget and Policy Center documented in a new report - AdultBasic Sings the Blues - that was rolled out in conjunction with the adultBasic Day of Action.

“We have completed our underwriting review and are sorry to advise that we must decline your request for insurance coverage"

We have completed our underwriting review and are sorry to advise that we must decline your request for insurance coverage…We regret that we are unable to consider based on medical history as noted in your medical records

I received this letter in the mail from Independence Blue Cross nearly 9 weeks after applying for coverage. As I roll over in bed, nearly two feet of snow lie on the ground and lying on my side trying to fall back asleep, my hand brushes over my chest and I feel it flutter and stop. Thud, thud, th-thud, stop…thud. My heart erratically beats on as my mind scrambles with anxiety. “Jesus, why is this happening to me” I lament, as I wonder if this will be the day that it does not restart.

adultBasic Premium Increases Will Make Insurance Unaffordable

The Pennsylvania Department of Insurance announced changes this week to the state’s adultBasic health insurance program that could make coverage unaffordable to thousands of Pennsylvanians who desperately need it to address urgent medical needs.

The changes to adultBasic, which will go into effect in March 2010, include an 80% increase in monthly premiums for the 3,500 participants who buy into the program at cost, from an average of $330 to $600 a month. Higher cost-sharing and utilization limits will also impact the more than 41,000 enrollees in the adultBasic program.

In a press release issued by the Pennsylvania Health Access Network (PHAN), Pennsylvania Budget and Policy Center Director Sharon Ward said: “Many individuals who cannot afford these higher premiums will have no recourse but to turn to hospital emergency rooms for treatment or to take on thousands of dollars in medical debt that they cannot afford.

Paying More for Health Insurance

Along with the other bad economic news this week we learned that everyone - regardless of age and employer - is paying more for their health insurance.

The Kaiser Family Foundation reported on September 24 that, since 1999, premiums for health insurance have more than doubled, while wages increased only 34 percent and general inflation rose 29 percent. Deductibles and other cost-sharing have increased and are likely to increase as well.

Today, the Washington Post reports that premiums for federal employees will jump almost 8 percent, on average, in 2009, more than twice the increase for 2008 and almost four times the increase in 2007. Plus, people in the most popular federal plan, the Blue Cross/Blue Shield plan, will see an almost 13% increase.

The Blues Merger

Jane Von Bergen has a really strong Inquirer piece this morning about health insurance competition in our state and how it plays out for some of the larger purchasers of insurance, What can happen if Blues compete. The part that will hit home the most for some of us is the story about the car dealership owner who plays the two off against each other for a better rate. That said, some of the stories about how the market opened up and how that played out for some of the region's big institutions also has a lot of food for thought in it.

Some advocates here are already organizing around opportunities presented by this merger. The "non-profit" Blues in the state are sitting on such an unbelievable amount of money in "reserves" that a massive earthquake could ravage the whole state and they'd probably still be able to cover the doctor bills. Then, of course, there is the question of who will keep The Big Blue honest if it controls the overwhelming majority of the insurance market.

Anyway, Philadelphians have a chance to weigh in on the proposed merger at the Philadelphia Sheraton on July 15th.

Insure-animals, from

Insur-Animals #1

This is kind of awesome. Pass Prescription for Pennsylvania (and Access to Basic Care). Health Insurance companies are evil.

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An Open Letter to Senator Clinton and Senator Obama, organized by the Philadelphia Unemployment Project

From the Philadelphia Unemployment Project

An Open Letter

April 10, 2008

Dear Senator Clinton and Senator Obama:

Healthcare has been central to each of your campaigns. As you work here in advance of the April 22nd primary, we wanted to alert you that healthcare is the number one opportunity we have to improve the lives of working Pennsylvanians right now. We, the undersigned, believe your campaigns could advance the cause of Pennsylvania’s reforms, should you choose to make them an issue.

Early last year, Governor Rendell unveiled an ambitious package of reforms known as The Prescription for Pennsylvania (Rx4PA, Rx4PA would expand access to health insurance with a high quality healthcare plan. With revisions from the House Democrats, that plan is now known as “Access to Basic Care,” and it passed the House this month in Senate Bill 1137.

Rx4PA would also rein in the forces that have driven up the price of insurance in the small group market, reward employers already providing coverage and insure that no one with a pre-existing condition is denied coverage.These also passed the House of Representatives in House Bill 2098 and House Bill 2005.

If these reforms succeed in the Commonwealth, it will make the arguments for either of your national plans much stronger. Rx4PA’s success should also galvanize your allies in Washington while chastening your opponents.

Rx4PA: The public's wide and deep support for healthcare reform and insurance for all!!!

Participants from Philadelphia heading to Harrisburg on October 2nd!

Here's one of the four buses that came from Philadelphia to rally for health insurance for low-income workers, and reforms in everyone else's health insurance program. All in all, about 150 to 200 Philadelphians made there way up to Harrisburg to back up the Governor's Prescription for Pennsylvania.

Help pass SCHIP – State Children’s Health Insurance Program.

From Philadelphia Citizens for Children and Youth

The U.S. House of Representatives will vote on the State Children's Health Insurance Program (SCHIP) bill on Tuesday (September 25th) and the Senate will vote on SCHIP by Thursday (September 27th) !

This bill will allow four million children to get health insurance who would otherwise be uninsured. It also protects children now covered so Pennsylvania will keep providing coverage to the 164,000 children currently enrolled in CHIP.

But, the President has threatened to veto it.

Your call is so important because it will take a big vote (at least two-thirds) for the House and Senate to show the President it will reject his ill-considered veto. Four million children need you to call. Tell your Representative: “I'm a constituent who thinks covering four million more uninsured children is one of the most important votes you can take. Please vote for the State Children's Health Insurance Program bill . ”

Health insurance's stifling pressure and how PA could have a comparative advantage

The Inquirer reported this week that health insurance costs about the same as an economy car to cover the family each year.

Some standout quotes from the piece by Jane Von Bergen:

Health insurance premiums for the average family topped $12,000 in 2006 - more than the cost of an economy car - according to an annual survey released yesterday.
"It's the growing anxiety on the part of the public which is moving health care up the political agenda," said Drew Altman, president and chief executive officer of the California-based foundation.
Annual premiums average $12,106 for families, with workers, on average, picking up $3,281 of the cost. Coverage for singles costs $4,479, with individuals paying $694.

Workers in companies with fewer than 200 employees pay a larger share of the premiums for family coverage than do their counterparts in larger companies.

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