MacDonald column contains errors
Last week this newspaper published a column by Rep. Bruce MacDonald (D-Boothbay) entitled, “Health care needs to be accessible and affordable.” I can agree with Rep. MacDonald on that idea.
But it is hard to understand why Rep. MacDonald would want to publish a column on health insurance so obviously wrong on so many points. Regardless, he did. And I will discuss some of the fallacious points one at a time.
MacDonald starts off by calling the legislature’s recent health insurance reform law “The health insurance rate hike the Republicans passed last year.” First of all, is not a rate hike – it is the first health insurance rate reduction ever.
The overwhelmingly positive Gorman Actuarial report commissioned by Maine’s Bureau of Insurance says that the reinsurance pool for the individual market in the law will reduce premiums by 12 to 15 percent, on average. They also project that younger, healthier people entering the individual market should reduce rates by an additional 3 to 5 percent, on average.
In the first year, the study estimates that in the small group market, 84 percent of the members and 73.8 percent of the groups will pay less as a result of broadening the community rating bands under PL 90. In the second year, they project that 93.6 percent of the members and 82.5 percent of the groups in the small-group market will pay less.
The Wall Street Journal said this: “the 2010 electoral wave carried in Republican Governor Paul LePage and a GOP legislature, and they took modest steps to deregulate the insurance market ... The returns are now rolling in for the new coverage that can be offered starting on July 1, and premiums are falling by as much as 69 percent for Maine's dominant insurer, Anthem.”
These lower rates for most of the health insurance market in Maine are a first. After years of ill-advised experiments that only produced higher rates, Maine has used simple, common-sense market-reform strategies that have been successful for years in many other states. But they aren’t just predictions. Anthem’s latest rate filing was for an average 1.7 percent – a record low increase. If one takes into account the increase in cost of care, this is truly a big break for health insurance consumers. For MacDonald to call these successful reforms “rate hikes” is disingenuous, to say the least.
And compare that to the past ten years – according to the Maine Bureau of Insurance website, Maine’s average yearly rate of increase in the small group market over the past 10 years has been around 19 percent. In the individual market, the average increase has been 13 percent. This is the result of decades of health insurance regulatory experiments. These experiments, supported by Rep. MacDonald have clearly failed.
I’m baffled by this statement: “I, along with my colleagues supported the purchasing of health insurance across state lines.” That simply isn’t the case. The idea of buying health insurance across state lines has come up three different times since MacDonald has been in the legislature and he and his Democratic colleagues voted against it every time. In the 124th legislature, I sponsored “An Act to Allow Maine Residents to Purchase Health Insurance from Out-of-state.” This bill had a lot of momentum and a good chance of passing but MacDonald, along with his colleagues, worked hard to make sure that bill didn’t pass. Finally, in the 125th and without MacDonald's support, the law passed, which will allow this practice starting in 2014. How MacDonald can claim he supported out-of-state insurance when he voted against it every chance he got leaves me incredulous.
Here is another statement in MacDonald's column that is erroneous: “The new law allows insurance companies to force people to travel long distances to receive care at big, urban hospitals instead of being allowed to go to your local hospital or doctor.” The truth is that finally, insurance companies can offer incentives to participants to travel. That is all. If you don’t want to travel, you don’t have to – you are still covered at your local hospital.
The Maine State Employees health plan, which is known as a “Cadillac” plan, has included this incentive provision in their coverage for quite a few years. Not only has it saved employees and taxpayers money, employees have received higher quality care. It is all about choice.
Has anyone in Maine been forced to travel by an insurance company since the passage of the out of state health insurance law? No. It is illegal for an insurer to require you to travel. That is the law. The statement by MacDonald is utterly false and frankly, quite silly.
And yet again, there is another whopper: “The new law also made it easier for insurance companies to increase health insurance rates without approval.” And again, this is simply not true. The arduous rate filing process under certain very strict conditions has been streamlined. That is all. The Superintendent of Insurance will still review all rate hikes, still use all of the same standards and may still take action in the form of fines and/or restitution if rates are found unnecessarily harsh or discriminatory.
This change will ultimately benefit consumers as insurers will be able to follow the market more closely and they won’t have to predict market conditions a year in advance. The bottom line is that insurance companies cannot and will not “increase health insurance rates without approval.”
Rep. Bruce MacDonald’s column on health insurance is a veritable onslaught of misinformation. Sadly, it is part of a state-wide barrage of election-year misinformation aimed at discrediting the accomplishments of the Republican-led 125th legislature. These accomplishments include not only health insurance reform, but healthcare reform, tax reform, welfare reform, pension reform, business and labor regulatory reform and more. Prepare for a siege.
State Rep Jonathan McKane currently is serving his fourth term in the Maine House of Representatives and his third term on the Insurance and Financial Services Committee. He represents District 51 which includes Damariscotta, Newcastle, Edgecomb, Bristol, South Bristol and Monhegan.
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