Bad news for consumers. Anthem-Cigna merger hearing has been post-poned by the MO Dept of Insurance. A Missouri hearing would have given the department the opportunity to look into how the merger would affect MO consumers before it goes to a federal judge.

The department held a similar hearing for the merger between Aetna and Humana and ruled against this merger. A similar decision would have been important for the federal judge to know before ruling.

http://www.stltoday.com/business/local/missouri-department-of-insurance-postpones-anthem-cigna-hearing/article_efd3bbd5-f3f5-5df0-b894-fae728099bdf.html

Today marked the first day of the federal trial over the proposed Anthem-Cigna merger which would create the nation’s largest health insurance company. Government antitrust lawyers are attempting to block this $48 billion deal which threatens to reshape the U.S. market for health coverage.

http://www.usatoday.com/story/money/2016/11/21/antitrust-trial-over-aetna-cigna-merger-begins/94222422/

The U.S. Department of Justice is challenging what it says is the largest merger in the history of the health insurance industry. On Monday, the Justice Department will begin arguing its case against Anthem’s $54 billion acquisition of Cigna Corp.

This merger would be particularly painful for St. Louis area consumers where these two insurers have a significant portion of the market share.

http://www.stltoday.com/business/local/consumers-should-pay-attention-to-insurance-antitrust-case/article_5a24485f-b821-5d4f-969b-904c1ecd1867.html#utm_source=stltoday.com&utm_campaign=BusinessNewsletter&utm_medium=email&utm_content=1DBDAE0183C0B49F9CB94AD3EE8564A5EF7394FF

The Affordable Care Act made health insurance accessible for millions of Americans. But rising rates, a lack of transparency in policy changes and little oversight in the process puts the entire system at risk.

Rates in MO are rising by alarming rates and the data behind these rates hikes are questionable.

http://acasignups.net/16/06/01/2017-rate-request-early-look-missouri

http://www.stltoday.com/news/opinion/mailbag/americans-deserve-better-than-choosing-among-crummy-insurance-plans/article_ea5d9127-29e2-5bc7-8301-1f7d3bf2535d.html?utm_medium=social&utm_source=facebook&utm_campaign=user-share

Gov. Jay Nixon today signed into law a bill that will help protect Missouri healthcare consumers. Senate Bill 865 gives authority to the Missouri Department of Insurance to review rates for health plans offered under the federal Affordable Care Act. Currently, the only review of those rates could be done by federal regulators, acting on behalf of the state.

https://governor.mo.gov/news/archive/gov-nixon-signs-bill-protect-consumers-allowing-state-review-rates-health-insurance

Legislature Can Still Help More Missourians Get Healthy, Stay Healthy

It’s true the Missouri General Assembly failed in the legislative session that ended May 17 to expand the Medicaid program to include more that 260,000 Missourians.  Most of these uninsured people who would become eligible for health care are working but poor.

According to a study in the New England Journal of Medicine, 1,500 Missourians will die each year until the state legislature expands the program.  Others will continue to face untreated illness and financial devastation because they are uninsured.

Consumers must let state legislators know they still have the opportunity to
save lives, alleviate suffering, create jobs and keep hospitals open throughout the state.

Tell the members of the Missouri House and Senate who represent you that you want them to continue working to expand Medicaid until they get it done.

Here’s a quick link to find your MO State Representative and Senator.

Click here to send a message to your senator.

Click here to send a message to your representative.

TAKE ACTION NOW to give all Missourians have access to quality, affordable health care.

Click here to read why economist Paul Krugman says the Affordable Care Act – Obamacare – can succeed.

More Information

We need to expand Medicaid in Missouri. In this tough economy, more Missourians than ever are out of jobs and many are single parents making barely enough to survive, let alone support a family. Under the national health reform law, Missouri has an opportunity to expand Medicaid to provide health insurance to single parents and childless adults who earn up to 133% of the federal poverty level, or about $25,000 for a family of three. Taking advantage of this expansion is both the right thing to do for Missouri Consumers and the smart thing to do for our State.

Expanding Medicaid is the Right Thing to Do:

• Being able to see a doctor is a right, not a privilege. Working families should have the right to receive basic medical care when they need it, but tens of thousands of working Missourians can’t qualify for basic health care, and 877,000 currently have no health insurance at all. That’s why Consumers Council of Missouri  is working to expand Medicaid coverage to help insure those who need it the most, like families with children who are working hard to make ends meet. Now is not the time for Missouri to start neglecting its working families.
• Medicaid saves lives and prevent thousands of deaths every year in Missouri. Expanding Medicaid will help allow 255,000 more hardworking Missourians who earn just a fraction of the federal poverty line to purchase insurance. A recent study shows that expanding coverage could even save the lives of as many as 6% of the people who enroll.
• Missouri currently makes it harder than almost any other state to qualify for Medicaid. Under today’s rules, a single mother of two can’t qualify for basic health care through Medicaid if she makes anything more than $3,504 per year – just 18% of the poverty line. That’s just wrong.
• More than 877,000 Missourians are uninsured.  Thisdevastates families, weakens our communities and overburdens our hospitals.  Since the general assembly cut health care benefits for low-income families in 2005, there are now over 877,000 uninsured—that’s one in every seven Missourians. Expanding Medicaid saves Missouri money in the long run and would help allow 255,000 more hardworking Missourians who earn just a fraction of the federal poverty line to purchase insurance. A recent study shows that expanding coverage could even save the lives of as many as 6% of these new enrollees.
• Missouri spends hundreds of millions on tax breaks for big corporations – including insurance companies – that are making record profits. If we’ve got the money to pad corporate bank accounts, we’ve got the money to invest in making sure all of our neighbors have access to health care – especially the low-income working families who need it most.

Expanding Medicaid is the Smart Thing to Do:

• Expanding Medicaid will save hundreds of millions of dollars for Missouri in the long run.  If we don’t expand Medicaid, Missouri hospitals could lose nearly $400 million in funding this year alone. This would force 40 to 50 percent of our state’s rural hospitals to close. In fact, losing these hospitals—and the thousands of jobs they create—means it would probably cost Missouri taxpayers more NOT to take the Medicaid expansion. Expanding with federal dollars will allow Missouri to focus on important priorities like education and public safety.
• Expanding Medicaid means thousands of good jobs in Missouri – more than 24,000 in the first year, according to a new study by the University of Missouri.
• Choosing not to expand Medicaid force 40-50% percent of our state’s rural hospitals to close. If this happens, tens of thousands of Missourians will be left without a local hospital, leaving both the insured and uninsured with fewer options and resulting in further overcrowding of our remaining hospitals.
• Expanding Medicaid is affordable for Missouri, with the state paying nothing for the first three years. The national health care reform law provides more than $8 billion for Missouri, meaning our state won’t have to pay anything until 2017 and only 10% of the expansion costs after that.

Missourian consumers want action to ensure access to affordable health care.  Today, 877,000 Missourians don’t have insurance, but it doesn’t have to be that way. We can act now to expand Medicaid so more working families and persons with disabilities can qualify. Doing so will create thousands of new jobs, and save the state hundreds of thousands of dollars. Most importantly, it will save lives and make sure our hard-working neighbors are able to see a doctor. It’s the right thing to do, and the smart thing to do for Missouri consumers.

St. Louis, MO (July 30, 2015) — Consumers Council of Missouri is calling on the U.S. Department of Health and Human Services to investigate projected rate increases from Coventry Health Insurance and four other Missouri insurers, each of whom has proposed raising rates by more than 10 percent in 2016.

Coventry Health Care, which is owned by Aetna, is one of the major carriers on the federal exchange for Missouri.  It has filed for 2016 rate increases of more than 20 percent.  Four other insurers have proposed 2016 increases exceeding 10 percent, which is the threshold the federal government set for challenges.

Missouri is the only state in the country in which the Department of Insurance has no authority over health insurance rates and in which health insurers do not even file their rates.  As a result, Missouri consumers are dependent on HHS for information regarding health insurance rate increases, and under the requirements of the Affordable Care Act, HHS reviews health insurance rates for Missouri.

HHS made no rate information public regarding rates proposed for 2014 and 2015.  But this year, after CCM filed a Freedom of Information Act lawsuit seeking the Missouri rate filings, HHS has revealed the rates for all states at a new website,www.ratereview.healthcare.gov.

CCM wants YOU to help!

Please comment on the excessive rates

proposed for 2016.

Here’s how:

Look at these documents related to CCM’s comments on unreasonable rates:

•  CCM’s letter to HHS seeking a hearing on 2016 rates filed by Coventry that increase as much as 28.9 percent and deem the rates unreasonable.  We also ask HHS to find unreasonable the rate increases above 10 percent filed by four other carriers.

•  A summary of the reasons rates proposed for Missouri are unreasonable.

•  Background of on the proposed rate increases for Missouri.

Then CLICK HERE to email your comments.

Some pointers:

•  Subject line – Comments on ACA health insurance rates proposed in Missouri for 1-1-2016

•  Ask the Department of Health and Human Services to deem the rates unreasonable because of specific reasons — choose the ones you like best from the summary and background documents available above.

•  Your comments don’t have to be long but they should be substantive.

•  The only rates that can be challenged are those that exceed 10 percent increases.

•  Sign the email with your name and address.

If you want to get into more detail, read the documents below.

More specifically, if you get your health insurance from one of the five insurance companies that has proposed rates in excess of 10 percent, please comment specifically on it.  (If you comment on a specific plan, put the plan description and number in the subject line.)

Click here for Missouri 2016 Rate Overview.

Click on these links to see comments on the following companies’s plans:

Blue Cross Kansas City Rate Filing HIOS Issue ID #34762 1-1-16.

Comments on Kansas City Coventry Rate Filing HIOS Issue ID #44240 1-1-16.

Comments on St. Louis Coventry Rate Filing HIOS Issue ID #44527 1-1-16.

Cox Rate Filing HIOS Issue ID #96384 1-1-16.

Humana Rate Filing HIOS Issue ID #30613 1-1-16.

United Rate Filing HIOS Issue ID #14162 1-1-16.

KWMU, July 31, 2015

Large rate increases for health insurance may be in the works for some Missourians this year, but we won’t know the final prices for a few months.

Last month, insurance companies nationwide submitted their bids for rate increases. The Missouri proposals from Coventry Health Care were among the steepest, including a 29 percent hike for individual plans sold on Healthcare.gov. According to rate filings, Coventry’s rate increases could affect 70,000 people.

Because the state of Missouri does not review its own health insurance rates, federal regulators will decide whether the price hike is warranted. In the meantime, members of the Consumers Council of Missouri are sending letters to the U.S. Department of Health and Human Services objecting to the increases, and asking federal officials to hold a hearing.

The Consumer Council’s executive director, Joan Bray, has long advocated for Missouri to implement its own rate review process.

“There’s only five states in the country that don’t have an adequate rate review process. But Missouri’s the only one that has nothing,” Bray said.

After a lawsuit brought by the Consumers Council, HHS began publishing the proposals for rate increases on its website. Only companies proposing an increase of 10 percent or higher are required to file the paperwork.

“I wouldn’t be surprised if the rate increase is higher this year. And that’s because in general health spending is starting to increase again,” said Tim McBride, a Washington University health economist.

Regulators often negotiate the rate proposals down to more reasonable increases, so speculating on the rate bids is likely premature, McBride said. (He discussed it more broadly on his blog). But he added that the market is still seeing inflation of 4 to 6 percent compared to last year.

“Coming out of the recession, the first couple years of the Affordable Care Act, healthcare inflation was about the lowest it’s been. But it’s starting to return a little more to its more traditional increases,” McBride said. “I don’t think it’s out of control yet, but we’re certainly watching it.”

Aetna spokesperson Rohan Hutchings wrote in a statement that Coventry’s proposed double-digit hikes “simply reflect the costs” of doing business:

“For 2016, we expect that medical costs will grow by 8-10% in the individual market. Other factors driving rates include changes in the reinsurance program (approximately 5-6% increase across all markets), risk pool experience, and taxes and fees,” it read.

Meanwhile, health insurers have enjoyed significant boosts in their market share. Since the implementation of the Affordable Care Act,  16.4 million previously uninsured people have enrolled in health insurance, according to the federal government.

Final rate increases will be published in the fall.