July 20, 2013

Maine insurer wants its rates kept private

Maine Community Health Options says releasing the data now might give its insurance exchange rival an unfair edge.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

A co-op, one of two insurers offering coverage on Maine's health insurance exchange, has asked the state Bureau of Insurance to keep its proposed health insurance rates a secret temporarily.

On Oct. 1, individuals can begin signing up for insurance on the exchange, a key part of the federal Affordable Care Act. The act is designed to allow people who don't have access to affordable insurance to purchase individual coverage on the exchange. Those earning 100 percent to 400 percent of the federal poverty level can qualify for subsidies to help them buy insurance on the exchanges.

The state insurance bureau, in a July 5 letter, ruled that the rates are a public record but agreed to delay releasing them to allow Maine Community Health Options co-op a chance to argue its case for keeping them private. In any event, the rates would be public by July 31, when the insurance bureau submits them to the federal government, which will give the final OK.

The Portland Press Herald submitted a Freedom of Access Act request on Friday to the Bureau of Insurance, seeking the proposed rates for both Maine Community Health Options and Anthem Blue Cross and Blue Shield, the only two providers that will offer health plans on the exchange in 2014 in Maine. Anthem also submitted its rates this week, according to a company spokesman.

In a brief filed with the insurance bureau, Maine Community Health Options officials said they were worried that its rates were public, Anthem would use them to engage in "predatory" pricing by setting artificially low rates to drive the co-op out of the market.

"As a completely new insurance company, MCHO is not in the financial position to withstand predatory pricing by its competitor," said the company's filing with the insurance bureau. 

A hearing was held at the Bureau of Insurance in Gardiner on Friday, but no decision was made.

"We have a lot riding on this," Kevin Lewis, CEO of Maine Community Health Options, told the Press Herald on Friday. "We want to make sure there's a level playing field, and that the competition is based on fair play."

Maine Community Health Options is being supported by a $62 million federal loan, according to the filing.

However, an Anthem spokesman, in an email response, said that the company has not asked to see the co-op's proposed rates.

"Like other carriers in other markets, Anthem Blue Cross and Blue Shield of Maine supports the right of carriers to keep new product rates confidential prior to the formal approval process to ensure a level playing field," wrote Anthem's Christopher Dugan in the email.

Since Anthem has also now submitted its rates for approval, it would be theoretically possible for Anthem to change its rates, but would be logistically difficult to do by the July 31 deadline, said Bureau of Insurance spokesman Doug Dunbar.

Anthem initially claimed confidentiality in its proposed rates, but did not object when the state ruled that the rates are a public record, Dunbar said.

Dunbar said the bureau's concern was not about whether the proposed rates would be made public, but when. Dunbar said he's not aware of any public hearings or comment periods to allow the public to weigh in on the proposed rates before the federal government decides whether they are appropriate.

Mitchell Stein, policy director for advocacy group Consumers for Affordable Health Care, said he doesn't believe the lack of public input or the organizations' requests to keep their proposed rates secret is a problem because of the competitive nature of the new insurance exchanges.

"It will be in each firm's best interest to price them as competitively as possible, because if one's too expensive, you can just choose the other one," Stein said.

Stein said that after July 31, there will be plenty of time to evaluate the rates before people start enrolling on Oct. 1.

As for whether the rates will be more or less expensive than insurance plans available today, Lewis said only that it was a complicated issue that will become more clear over time.

"Everyone involved with the ACA would like to see improved affordability related to last year," Lewis said. "We have a lot of work to do collectively to make health care coverage less expensive."

Joe Lawlor can be reached at 791-6376 or at:

jlawlor@pressherald.com

Twitter: @joelawlorph

 

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