A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Insurers: "We're Closed Now"

Insurers: "We're Closed Now"

April 6, 2010

We're Closed sign
If you want to buy health coverage from any of the state's major plans, like Blue Cross Blue Shield, Harvard Pilgrim, Tufts or Fallon, it appears you're out of luck. This morning, all of the major non-profit plans began refusing to sell coverage to individuals or small groups. This was in response to the state's rejection of proposed rate increases of up to 35%.

We're still trying to confirm the details, and will update the blog as we learn more.

(UPDATE Wednesday morning: Based on today's Globe article, it appears that BCBS is still selling policies directly through their website and brokers, but not through the Connector. They are quoting the rejected numbers and telling customers that they are suing the state over the rates and will provide a credit on their account in the future if they need to. HPHC and Tufts are not offering any coverage. DOI Commissioner Murphy has asked insurers to post their 2009 rates by Friday and has threatened to penalize them with fines if they do not do so.)

The Connector's Commonwealth Choice website states that "With one exception, insurers must pull their Commonwealth Choice plans until they reset the rates. We expect new rates soon." In a conversation with a sales agent from Harvard Pilgrim, we were told that they hope to resume sales on April 15.

Pulling out from the market is an extreme, nuclear option response to a pricing dispute, and holds consumers hostage. Our Helpline heard today from someone who just started a new job with a 3-month waiting period before coverage kicks in. The person was looking to buy individual coverage for the gap period, but was shut out by the insurers. Thousands more must be in the same situation.

Health reform's success emerged from a shared responsibility process, which includes respect for the consumers who are obligated by law to have coverage. For insurers to unilaterally take their ball and go home seems like a negation of the moral and legal obligations of our system. This is heightened by the fact that the only insurers left in the market are the for-profits, like CeltiCare and Aetna. The non-profit insurers, who so often have eagerly partnered with consumers to improve care, seem to have left behind their obligations as public trustees.

Veronica Turner, Vice-President of the 1199SEIU health worker's union, said, “If hospitals shutter their ER doors, people die, so it’s disturbing that insurance executives would so recklessly slam the door on consumers who need healthcare coverage. The insurance executives have put profits over patients for far too long as their reserves and administrative costs have swelled over time. The insurers are unnecessarily shutting their doors as a negotiating ploy, and that’s not going to win them sympathy from the public, patients, or caregivers.”

We agree. At a time when insurers nationally are under close scrutiny, this action by our world-class carriers in only going to magnify pressures for public options and other more accountable structures - as witnessed by the comments on the Globe story. Let's hope that this gets resolved soon.