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Bill hypes health insurance scrutiny

Proposed legislation would let state residents examine insurers' rate requests

By , Columbian Port & Economy Reporter
Published: March 3, 2011, 12:00am

Washington health insurance regulators want the public to see and understand what only the government has the right to examine now: the reasons behind health insurance rate hikes.

Some health insurers that serve residents in Clark County already are sharing that information in Oregon, where insurers open their rate-request packages to public inspection and comment before any decisions are made.

House Bill 1220, proposed by Washington Insurance Commissioner Mike Kreidler, would install a new health insurance rate-review process modeled on Oregon’s system. It would let the public scrutinize an insurer’s rate-request package for individual and small-group plans before the rate is decided. Consumers would be able to study and make copies of a company’s actuarial formulas and statistics, and reasons for a proposed rate increase. They also would be able to comment on the request in a public forum.

Stephanie Marquis, a spokeswoman for Kreidler, said Kreidler’s office receives hundreds of calls annually from people who’ve been hit with double-digit rate increases and who want to know why. “The only thing we can say today is ‘Trust us, it’s justified, we looked at the rate filing and they made their case,’” Marquis said. “We can’t tell them what’s in the rate filing.”

Marquis said Kreidler’s bill is “for consumers to understand where their money is going.” To survive, the bill must clear the House by Monday. Marquis said she expects the House to vote on the bill today. It would apply to plans sold to people who obtain health insurance on their own and to companies that employ up to 50 workers.

Two of Washington state’s major insurers whose coverage area includes Clark County, Regence BlueShield and Group Health Cooperative, support Kreidler’s bill.

Premera Blue Cross, however, opposes the changes Kreidler wants. Eric Earling, a spokesman for Premera — which offers individual health plans in Clark County through its Washington state affiliate Lifewise — said insurance rate proposals change between request and approval, so sharing initial proposals with people could cause confusion.

Earling said Premera already shares comprehensive information with its customers about where their health care dollar goes, including a premium’s breakdown in medical and administrative costs, and the company’s profit.

In a Feb. 28 open letter to consumers, Kreidler wrote that Premera is “stonewalling” and only “wants you to see the filings once the rates are set.” He added that he’s hopeful that Premera will “join me, along with Regence and Group Health, and put an end to the pointless secrecy of health insurance rates.”

Earling said Premera is perplexed by Kreidler’s letter since the company is trying to work with state lawmakers to boost transparency. “We’re supportive of the goal of transparency,” he said. “We do have some concerns about the date at which (rate information) is made available.”

Leaders of Regence and Group Health have submitted letters in support of Kreidler’s bill. In a March 1 letter, Jonathan Hensley, CEO of Regence BlueShield, wrote that it would move Washington “in the direction of greater transparency” for consumers in the individual and small-group markets while keeping confidential “certain elements of rates associated with large groups and new products, protections we view as critical.”

Regence BlueCross BlueShield of Oregon — like Regence BlueShield, a subsidiary of The Regence Group — serves about 30,000 members in Clark County.

In a Feb. 28 letter, Pam MacEwan, vice president of public affairs and governance for Group Health, wrote that she believes “that more transparency in health care is fundamental in slowing the growth in health care costs.” Group Health offers individual health plans in Clark County through its affiliate KPS Health Plans.

If Kreidler’s bill becomes law, Marquis said, his office envisions a public information system like Oregon’s, where rate information and easy-to-use summary pages are posted online for public review. The summary information, Marquis said, could include how many people would be affected by a rate change, historical data on a company’s rate changes, and a breakdown of how much of a proposed rate change would go to medical and administrative costs, including salaries, and company profit.