Some Vermont consumer oppose health insurance rate hikes

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MONTPELIER >> Loren Mandell Wood of Burlington came into the world 11 days ago at an "out-of-pocket maximum" cost of as much as $5,100. On Wednesday, he did not appear prepared to pull that money out of his pocket.

And his mom, who testified at a state hearing on health insurance rates, said the family surely couldn't either.

"Our monthly premiums are $465 per person. That includes Loren, who's not yet contributing financially to our household," Bekah Mandell told the Green Mountain Care Board amid laughter in the room. "That means we pay a total of $1,395 a month in premiums alone. That's before we get to the copays and before we get to the deductibles. That's significantly more than our mortgage, and frankly it's significantly more than we can afford."

Mandell and six other people testified before the board against any rate increases for Blue Cross Blue Shield of Vermont for health plans it offers through Vermont Health Connect, the state insurance exchange set up under the federal Affordable Care Act.

The board is expected to decide by Aug. 13 on Blue Cross rate increase requests averaging 7.2 percent. Company officials agreed to drop to that level from an earlier request averaging 8.6 percent over the various coverage options it offers after actuaries working for the state board went through the company's numbers and found places to trim them, Blue Cross officials said.

Blue Cross has attributed its need to charge more in 2016 to increases in bills coming from doctors, hospitals and other providers, and reductions in federal support for the reinsurance that chips in to help pay for high-cost patients, said Cory Gustafson, the Blues' director of government and public relations.

During the hearing, Blue Cross officials defended their proposed higher rates and analysis by actuaries.

Donna Novak, founder of NovaRest Actuarial Consulting, testified for the state Office of the Health Care Advocate, which represents consumers, that Blue Cross could lower its rate increase to zero and still remain solvent, but quickly added, "I'm not recommending that."

She was then challenged by Blue Cross lawyer Jackie Hughes about the thoroughness of her analysis.

Another consumer who testified said he was struck by the exchange.

"In people's lives, they don't have that kind of solvency around health care," Dale Hackett said. "They don't have a savings account. Or they might have a savings account, and it'll be wiped out as soon as they get sick."

Blue Cross is expected to cover about 73,000 Vermonters through the Vermont Health Connect exchange next year. The one other private insurer operating through the exchange, MVP Health Care, covers about 6,000 people. It has asked for a 2.4 percent average rate increase.

Vermont's 14 hospitals are seeking budget increases averaging 3.6 percent this year.


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