Legislation protects consumers at fractional cost to insurance companies

0

It is difficult to have sympathy for insurance company representatives who complain about their profits — especially in this economy when everyday citizens are truly suffering.

That’s why we were surprised to read the guest column (Feb. 28) by Joel Allumbaugh, an industry representative, complaining about a bill, LD 1620, that would prevent health insurance companies from limiting lifetime insurance caps. Allumbaugh’s column argued that this bill would significantly drive up insurance costs in Maine.

Well, that’s just not true. Based on a survey of carriers in Maine, the Bureau of Insurance has concluded that these important consumer protections will impact premiums by a fraction of one percent.

The cost of eliminating those caps would be minimal — but the amount of difference it makes for those Maine families is immeasurable.

Advertisement

Insurance premiums don’t have to go up. Maine’s health insurers — already one of the most profitable industries in the state — will choose whether or not to pass this small cost onto their policyholders. That decision, unfortunately, is not in our hands.

Anthem is one of the largest providers in Maine. Last year its parent company, WellPoint, grossed $62 billion in total revenue and was ranked the 32nd largest company on the Fortune 500 list. Recent news reports show that the company’s profit margin increased from 4 to 7 percent.

With assets in that amount, they should hardly be pleading poverty — particularly when it comes to adding a small consumer protection to those who are already paying for insurance.

What good is insurance if it doesn’t cover you when you are sick? Caps on annual and lifetime benefits go directly against the real purpose of insurance, which is to cover your medical bills when you or a loved one is sick.

In Maine, health insurance companies have lifetime limits as low as $45,000 and as high as $5 million. The most common limit is $3 million. According to information provided by the Maine Bureau of Insurance, Anthem decided this year to limit the amount of care people could get, changing a majority of its plans from having no lifetime caps to having $3 million caps. This change happened despite National Health Reform efforts to eliminate lifetime caps.

Eliminating lifetime limits would not only help families who face high medical costs, but would also result in savings for state and federal governments. Independent financial analysis found that the government could save billions of dollars if people could maintain their private insurance rather than be forced onto Medicaid or into receiving hospital free care.

This is not a partisan issue, nor is it simply an issue in Maine. In fact, U.S. Sen. Olympia Snowe supports greatly increasing the current limits as part of the national health care debate.

We can’t continue to help Maine move in the wrong direction for our hard-working families.

The most common condition reported as meeting a lifetime or annual cap in Maine is cancer. The cost of cancer drugs is rising at 15 percent per year, as new and expensive drugs hit the market. Some of these drugs may cost $100,000 or more for a single course of treatment. Eliminating annual or lifetime caps would directly benefit Mainers battling cancer and fighting other chronic diseases such as hemophilia, Cystic Fibrosis, Parkinson’s and Multiple Sclerosis.

While the insurance industry claims Maine’s Legislature and our mandates to protect consumers have driven up costs and are of greatest concerns to their clients, Maine has one of the lowest rates of uninsured across the country. We consider that a success.

In Maine, insurance companies are required to offer a policy to any person regardless of their health status because of strong legislative protections. Insurers in other states, however, may deny coverage to people based on their health status, their gender, or even what community they live in. This practice just doesn’t fit with our values here in Maine.

We fight on behalf of consumers time and time again — from those who are pay their premiums monthly to those who are most vulnerable in our society.

This session, we are working on important legislation to make sure private insurance companies cover children with autism – a mandate that exists in many states across the country and will be a minimal cost for insurers. The change in legislation would save taxpayers about $250,000, yet only cost private insurance payers less than $2 every year. We are also considering legislation to require insurance companies to cover the cost of the latest technology in prosthetics, benefiting hundreds of Maine veterans and the disabled.

We legislate on behalf of those Maine people who sent us to Augusta to protect them, not the bottom line of a $62 billion company.

Democratic Rep. Seth Berry represents Bowdoinham; Republican Rep. Meredith Strang Burgess represents Cumberland.

Advertisement