State Insurance Regulators Deny Ratepayers Public Hearing on Highmark Rate Hike

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By Athena Ford, Pennsylvania Health Access Network (PHAN)
Originally published October 19, 2011 on the PHAN Blog

Thousands of activists with the Pennsylvania Health Access Network (PHAN) sent emails, signed petitions, called and showed up in person to ask the Pennsylvania Insurance Department for a real, public investigation into Highmark's proposed rate hike on the Special Care plan. But this week the department approved the increase, without holding a hearing.

Special Care is a limited benefit plan offered by the state's Blue Cross/Blue Shield providers. It was touted as an alternative when the Corbett administration ended the adultBasic health insurance program in February.

PHAN activists pushed back against Highmark's initially proposed 9.9% rate hike for Special Care so much so that the insurer immediately felt the pressure and reduced its request to a 4.9% increase.

Numbers, percentages, dollars and cents — that's not what we were fighting for.

You have to make less than 185% of the Federal Poverty Line (about $20,000 per year) to purchase the Special Care plan, which is overpriced and offers dangerously limited coverage.

Last year, Highmark's surplus increased by nearly 10%. They made enough extra cash to pay out bonuses to their top executives, pay their CEO $3 million and spend tens of millions more on advertising and lobbying.

So why is it that they need to raise rates on working Pennsylvanians who are already struggling to make the pricey monthly premium?

We don't know. We can't know, because once again Pennsylvania's Insurance Department is giving Highmark exactly what the company asked for without first launching a real, public investigation.

When an insurance company proposes a rate hike in other states, there is a hearing in which the company needs to prove the increase is necessary and justified. Often times, there is a consumer advocate.

These are the types of consumer protections that help keep insurance affordable. There are some good ones in the Affordable Care Act that help, too, like the Medical Loss Ratio which says that 80% to 85% of your premium dollars must be spent on actual care.

But Pennsylvanians deserve the same rate protections that folks in other states have. Health insurance is too important and too expensive to allow insurance companies to raise rates without reason.

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