Tag Archives: insurance

TN insurance commissioner takes umbrage at Obama remarks

In his Nashville appearance this week, President Obama said that state insurance commissioners need to be taking a close look at insurance premium increases proposed by companies. In a news release Thursday, Tennessee Commerce and Insurance Commissioner Julie Mix McPeak said that’s already happening.

From The Tennessean:
In responding to a question from Marian Hurst — a retiree in Mt. Juliet who buys insurance on the federally run exchange —about BlueCross BlueShield of Tennessee’s recent proposed rate increase, Obama said in his Madison speech on Wednesday that it’s important for the state’s insurance commissioner to actively question insurers.

“So I think the key for Tennessee is just making sure that the insurance commissioner does their job in not just passively reviewing the rates, but really asking, ‘OK, what is it that you are looking for here? Why would you need very high premiums?’ ” Obama said. “And my expectation is, is that they’ll come in significantly lower than what’s being requested.”

BlueCross BlueShield of Tennessee has requested on average a rate increase of 36.3 percent for insurance premiums in 2016. Other insurers on the exchange in Tennessee have requested average rate increases ranging from 0.4 to 36.3 percent.

McPeak had recently testified to a congressional subcommittee that the BCBS premium hike might not be big enough. Here’s her department’s news release sent to media:
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Haslam comments on King vs. Burwell

Here’s a block quote on Gov. Bill Haslam’s commentary on the King vs. Burwell ruling in a news conference, as reported by Richard Locker.

“Number one, I’m surprised,” Haslam said. I thought they would rule the other way.

“Number two, I’m disappointed in the sense that I really did think this would be an opportunity to fix some things in the law that were broken.

“Third, though, I am pleased for those folks who have insurance subsidies now and for the insurance companies that have a more predictable environment to operate in.

“So while philosophically I did not agree with the ruling, in terms of the smoothness of the market and people being able to obtain insurance in a predictable way, it’s good.”

…Q: How does the ruling affect the debate over Insure Tennessee?

Haslam: “I said all along it was really two separate arguments, two separate issues – that Insure Tennessee is about the people in the expanded (Medicaid) population. This (court ruling) is over people who are getting subsidies. There’s a little overlap: Insure Tennessee is about people up to 140 percent of poverty down to zero, and people with subsidies start at 100 percent of poverty.

Q: But some legislative leaders wanted to wait on Insure Tennessee until this decision came out. Already today, House Democratic Minority Leader Craig Fitzhugh has called for a special session on Insure Tennessee.
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TN reaction to King vs. Burwell ruling

Tens of thousands of Tennesseans will be able to keep the health insurance they purchased under President Barack Obama’s health care reforms in light of the U.S. Supreme Court’s 6-3 ruling on Thursday upholding tax subsidies given to Americans to make the insurance affordable, reports Michael Collins.

Some 156,000 Tennesseans have received the subsidies that enabled them to buy health coverage under the federal government’s insurance exchange, according to Families USA, a non-partisan pushing for affordable health care for all Americans.

Other estimates put the number of Tennesseans who received the tax subsides at more than 200,000.

A court ruling striking down the subsidies could have jeopardized health insurance for the Tennesseans and the other 8.7 million Americans who used the payments to make insurance affordable.

In Congress, reaction to the Supreme Court’s decision upholding the subsidies was divided.

U.S. Rep. Steve Cohen, a Memphis Democrat, praised the ruling and said Obamacare “is working and helping make health coverage affordable for millions of Americans.”

“I hope that this ruling will help the nation to see that the Affordable Care Act is a federal law that is helping Americans stay healthy and alive, and that it is here to stay,” Cohen said.

Cohen also urged the Tennessee General Assembly to “finally act to expand Medicaid so that our citizens can access the same benefits of the law that residents of other states do.”

…The other Tennessee Democrat in Congress, U.S. Rep. Jim Cooper of Nashville, also urged the legislature to expand Medicaid. “Tennessee legislators said they were waiting for the ruling,” Cooper said. “We now have it. They should finish the job.”

U.S. Sen. Bob Corker, a Chattanooga Republican, said the ruling affirms that it’s up to Congress to come together around “a responsible solution that provides relief from the damaging effects of the president’s health care law, including policies to provide far greater choice in the marketplace so affordable plans that meet the actual needs of Tennesseans can openly and effectively compete for their business.”

U.S. Rep. Phil Roe, a Johnson City Republican and one of a handful of physicians in Congress, said that regardless of the ruling, “the president’s health-care bill is so deeply flawed it cannot be fixed, and today’s ruling does not change that fact.”

TN insurance comish: 30% health insurance hike may be inadequate

Tennessee Insurance Commissioner Julie Mix McPeak told a congressional committee Wednesday that a proposed 30 percent increase in health insurance premiums may not be enough to cover losses from soaring medical claim costs, according to the Tennessean.

She said, for example, that the state’s largest carrier on the federally run exchange, BlueCross BlueShield of Tennessee, paid more than $1 for every $1 it collected in premiums, meaning it had a medical lost ratio of more than 100 percent.

BCBST had $471 million in claims for people with individual plans in 2014.

McPeak, on Capitol Hill by invitation to talk about rising health insurance premiums, told a subcommittee of the House Ways and Means Committee that substantial rate increases are being driven by medical trends and utilization, or how enrollees use health care services.

The state agency is asking health insurers to provide monthly updates on enrollees and costs because the companies had to write policies and forecast pricing with only a few months of data on the 2015 enrollees.

The lack of data on potential enrollees on the federally run insurance marketplace has largely been a mystery for an industry that relies heavily on claims to predict risk and costs.

The TDCI looks at the impact of rate increases for consumers as well as the impact on insurers, said McPeak, explaining that insurers “need to stay in business” in order to keep promises to members.

The state agency is in the process of reviewing rate requests, which range from 0.4 to 36.3 percent average rate increase.

BCBS 2014 earnings $200M despite losing $141M on ACA

Chattanooga-based BlueCross BlueShield of Tennessee earned $199.7 million during 2014 on total revenues of $10.8 billion, according to company filings with the Tennessee Department of Commerce and Insurance.

So reports the Times-Free Press. To continue:

The not-for-profit insurer said it lost $141 million on its health exchange plans sold under the Affordable Care Act due to heavier-than-expected health care claims by the 164,896 Tennesseans BlueCross covered under the new Obamacare plans. BlueCross’ tax bill also jumped 72 percent to a record high $463 million last year, largely due to new taxes levied under provisions of the Affordable Care Act.

But BlueCross offset those losses and extra costs with income from its commercial insurance, Medicare and TennCare businesses and the gain from the sale of the information technology company it uses, TriZetto.

BlueCross, which already insures nearly half of all Tennesseans, boosted its enrollment by 5 percent last year to 3.3 million members and boosted medical claims paid by 8 percent.

“Overall, we had a good year in terms of growth in memberships and revenues and had one line of business that didn’t perform as expected,” said Roy Vaughn, vice president of corporate communications for BlueCross. “We were able to get through last year based upon the breadth of our business and the benefit of a one-time gain in investments.”

Nearly two-thirds of the company’s profits came last year from a $126.1 million gain in investment income, primarily from the sale of BlueCross’s share in the $2.7 billion sale of TriZetto. BlueCross bought a piece of the health care information technology company it uses in 2008 but agreed to sell TriZetto last fall to Cognizant Technology Solutions.

Note: BCBS wants to raise premiums to cover the ACA losses. Previous post HERE.

AG opines costs of legislator insurance subsidies are public record

NASHVILLE, Tenn. (AP) — State Attorney General Herbert Slatery found in a legal opinion released Monday that the cost of lawmakers’ health insurance coverage falls under Tennessee’s open records laws.

Slatery said the amounts spent by the state are not confidential because they do not disclose any personal information about lawmakers.

The released records “pertain only to insurance coverage … that have nothing to do with treatment, diagnoses, or medications,” according to the opinion. “And especially not of any individually identifiable person.” (Note: Full opinion is HERE.)

The issue of lawmaker health benefits became a subject of attention as the General Assembly rejected Republican Gov. Bill Haslam’s proposal to extend coverage to 280,000 low-income Tennesseans.

Eighty-eight of 99 House members and 28 of the 33 senators are on the state employee health plan — including six of seven senators who voted to kill Haslam’s Insure Tennessee plan during a special legislative session in February.

Several state lawmakers expressed outrage that the state released a list of which legislators were on the state health plan. They became even more irate when the state released information to The Tennessean newspaper showing lawmakers had received nearly $6 million in taxpayer-subsidized coverage since 2002.

BCBS seeks hefty TN premium increase for ACA insurance

After losing $141 million in the first year of offering individual health plans through the federal Affordable Care Act, Tennessee’s biggest health insurer wants to raise premiums next year by an average of more than 36 percent, according to the Times-Free Press.

BlueCross BlueShield of Tennessee, which enrolled nearly two-thirds of the 231,00 Tennesseans who signed up for health insurance exchange plans last year, said it initially underestimated the number and cost of the medical claims filed by new enrollees.

When the plans debuted last year, BCBS’ popular Silver option was among the cheapest plans anywhere in the country.

BlueCross Vice President Roy Vaughn said the nonprofit insurer’s mission was to serve the entire state as affordably as possible under the ACA, or Obamacare.

“It was a new market, and as we filed our initial rates for 2014 we had no data on the population that we would cover. We did not foresee the kind of medical costs that we’ve experienced with this group of members,” Vaughn said.

Under Obamacare, insurers may no longer deny coverage or charge people more if they have pre-existing medical conditions. In the first couple of years of the health exchange plans, BlueCross said 3 percent of its individual plan members accounted for 50 percent of its medical costs — a far bigger share than what had been forecast.

If state regulators approve the proposed rate hikes, average individual rates would rise to more than 60 percent above their 2014 levels. Last year, BlueCross raised its individual plan rates by an average of nearly 19 percent.

Most of the other insurers offering individual plans in Tennessee also are asking for double-digit rate increases in 2016, even though trends in medical costs and employer plan premiums are not rising as fast as in previous years. Tennessee’s health insurance co-op plan, the Knoxville-based Community Health Alliance, is seeking a nearly 33 percent rate increase, while Humana is asking for a 16 percent increase.

Sen. Crowe a convert in Insure TN revival?

Excerpt from a column by Robert Houk:

A town Hall meeting last week on the Insure Tennessee plan had something of a tent revival feel about it, and it wasn’t because it was held at a church in downtown Johnson City. No, it was hearing the panelists talk about how expanding TennCare (Medicaid) would be moral, just and in keeping with the Golden Rule that made me think of a fervent religious gathering.

Of course, one presenter was a member of the clergy. The Rev. Jane Taylor, a pastor at First United Methodist Church… got an “Amen” from many in the audience… and from her fellow panelists, including Dr. Patrick MacMillan, an assistant professor at East Tennessee State University’s Quillen College of Medicine. MacMillan said expanding health coverage to 288,000 of Tennessee’s working poor “is simply the right thing to do.” He also got the loudest applause of the evening when he said: “Politicians have health insurance. Why can’t the working people of Tennessee have health insurance?”

This was in reference to recent reports that many lawmakers in the state General Assembly are receiving state-subsidized medical insurance. One of them, state Sen. Rusty Crowe, R-Johnson City, said he was perfectly fine with the public knowing of his health care coverage. Crowe, who helped defeat Insure Tennessee during a special session in February, only to play a crucial role in trying to revive it a month later, said he is now convinced the plan is a good thing for Tennessee.

That’s also the thinking of 64 percent of state residents polled on the subject by Vanderbilt University.

Crowe also told the crowd Wednesday that politics and ideology are the reasons many of his Republican brethren on Capitol Hill are willing to turn down nearly $2.8 billion in federal funds to help the low-income Tennesseans.

Former Sen. Ford still on state health insurance (name omitted earlier)

State officials inadvertently omitted former state senator John Ford of Memphis from a list released to the media of 148 former Tennessee legislators who remain on the state health insurance plan after leaving office, reports the Commercial Appeal.

The office of benefits administration notified reporters that it inadvertently left Ford’s name off the list requested by various media. Ford, 73, resigned from his state Senate seat May 27, 2005, after his arrest on bribery charges with four other then-current and former lawmakers in an undercover FBI operation. He was convicted two years later of accepting $55,000 in cash payments from representatives of a fake FBI company attempting to win state computer recycling contracts and served four years and four months in federal prison.

State law allows former lawmakers elected to at least one term to retain their state health insurance by paying premiums ranging from 20 to 40 percent of the costs, depending on their years of service.

As a 31-year veteran of the legislature, Ford pays 20 percent of the cost of his state health insurance coverage; the state pays 80 percent. Two other former lawmakers convicted in the “Tennessee Waltz” probe, former senators Roscoe Dixon of Memphis and Ward Crutchfield of Chattanooga, also remain covered.

Note: Previous post HERE.