http://www.publicintegrity.org/2013/11/04/13676/what-congress-didnt-say-obamacare-outlaws-policies-are-essentially-worthless?utm_source=email&utm_campaign=watchdog&utm_medium=publici-emailFairly well-known insurance industry whistle-blower Wendell Potter writes:
As I watched Health and Human Services Secretary Kathleen Sebelius being grilled by members of the House Energy and Commerce Committee last week, it was immediately clear to me just how many of them are in the pockets of the industry I used to work for.
Former colleagues of mine undoubtedly had a hand in writing the members’ comments and questions. Their behavior showed just how much more willing they are to protect the profits of health insurers than protect the health and financial well- being of their constituents.
I got the same treatment from many of those committee members when I provided testimony in March — or tried to. I had been invited to talk about the business practices of insurers — practices that have contributed to the rising number of uninsured and underinsured Americans. Among them: refusing to sell policies to millions of us because of preexisting conditions and charging exorbitant premiums for skimpy coverage to others.
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As I wrote in Deadly Spin, a years-long industry strategy has been to shift more and more medical expenses to patients. As part of that strategy, big insurance firms bought smaller companies that specialize in limited-benefit plans, which often provide such skimpy coverage that some insurance brokers have refused to sell them.
Cigna, for example, marketed a limited-benefit plan to narrowly targeted prospective customers: mid-sized employers with high employee turnover, such as chain restaurants. The underwriting criteria was specific. The average age of an employer’s workers couldn’t be higher than 40 and no more than 65 percent of the workers could be female. (Insurers have long charged women more than men because in their eyes being born female is a pre-existing condition.) In addition, employers had to have a 70 percent or higher annual employee-turnover rate, meaning that most employees wouldn’t stay on the job long enough to use their benefits. Employees also could not get coverage for care related to any pre-existing condition during their first six months of enrollment.
Limited-benefit plans like that one, blessedly, will not be available next year, and that’s because of the Affordable Care Act. Neither will plans with sky-high deductibles. Another way insurers have shifted costs to patients in order to enhance profits: luring or forcing them into plans with such high deductibles they join the ranks of the underinsured the moment they enroll. When people in these plans get seriously sick or injured, they are on the hook for thousands of dollars in medical bills they’ll have to pay out of their own pockets.
Millions of Americans — including my son, Alex — got letters from their insurers in the years before the ACA was enacted informing them that their plans were being discontinued. Why? To fulfill the industry strategy of moving people out of plans with affordable co-payments and co-insurance obligations and into high-deductible or limited-benefit plans. Such plans are far more profitable.
