April 01, 2010

Division of insurance rejects small group health rates increase

The thing I find the most amazing about this is that the rejected rates today for April, May and June is that---employers started working on their April renewals in Februar and have already made their decisions for April. Should not the Division of Insurance be approving or rejecting these rates at least two months before the effective date? This is only going to causeeven more confusion for strained groups and what will this really do. Answer--nothing. In fact the caps on what insurance companies may in the long run cause more damage then good.




Here (again) are some steps the Commonwealth of Massachusetts can take to provide real relief to small businesses:



1.Stop the never-ending open enrollment! People are able to sign up one date, have all their medical conditions covered the next and then cancel their insurance when all the medical conditions are treated. Only to do it again six months later, then we wonder why insurance premiums are out of control for everyone else? Just like any private/public carriers, or even Medicare, we need to limit open enrollment to one month per year

2.Allow employers to buy coverage without prescription coverage and while still meet MCC (minimum credible coverage) standards to avoid the penalty. The prices of the major pharmacies to buy prescriptions out of pocket without health insurance are incredible. Walmart, last time I checked, sold over 400 drugs for $4 for a 30 day supply or $10 through the mail for a 90 supply. Conservatively this alone would be a 10% reduction in premiums.

3.Allow employers to opt out of all the state mandates, like many self insured groups do. This also would conservatively take another 10% off premiums.

4.CommonwealthCare bases their acceptance solely on income. An asset test, like we do for Medicaid, needs to be added. It makes no sense for a person of substantial assets or the owner of a "cash" business, but who may have actual declared income under 300% of the Federal poverty level have his, or her, insurance premium subsidized by the rest of us. Also their are many people participating in this program that are eligible for an employer sponsored health plan, which make them ineligible for Commonwealthcare. An audit needs to be done.

5.We need to increase the penalties on individuals that do not have health insurance, although I question in the end how this can be enforced. Currently a person can claim that his medical beliefs do not allow for the purchase of health insurance. How is the Commonwealth of Massachusetts going to prove, or disprove, someone religious ideology.

6.Tort reform. I am not a lawyer, so I will let someone else get into more detail on this.

Lets focus on real ways, as outlined above, to control costs not political maneuvering which actually causes more harm then good.

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