Protesters criticize insurance rate lawsuit

Anthem Blue Cross Blue Shield seeks to overturn a decision denying the firm a guaranteed profit margin. October 8, 2009 Portland Press Herald/Maine Sunday Telegram AUGUSTA — More than 100 people stood in the pouring rain Wednesday to protest Anthem Blue Cross Blue Shield's lawsuit against the state. The lawsuit seeks to overturn a decision by Maine's insurance superintendent denying the company a guaranteed 3 percent profit margin. Protesters rallied on the lawn of Kennebec County Superior Court, where the lawsuit was filed Aug. 21. Oral arguments are expected to be heard next month. Phil Bailey, state director for Change That Works, a grass-roots organization supporting health care reform, told the crowd that Anthem's rates in Maine have gone up 89 percent and profits have increased 79 percent in the past seven years. "We're gathering here, asking them to drop the suit against taxpayers of Maine, who already can't afford their polices, and return the money – that they are using to lobby against health-care reform – to their ratepayers in the form of reduced premiums," Bailey said. Anthem submitted a request last winter seeking an average 18 percent rate increase for its four individual health care insurance products, affecting about 12,000 of its 400,000 policy holders in Maine. The request reflected the medical risks of doing business in Maine, company officials said. In its lawsuit, the company said Maine has high rates of asthma, heart disease, diabetes and other chronic illnesses, a high number of smokers and a restrictive regulatory environment. "Unfortunately, the individual market premiums are merely the symptoms of a larger underlying problem in Maine's individual market: rising health care costs," said Anthem spokesman Chris Dugan. After holding several public hearings, Insurance Superintendent Mila Kofman cut Anthem's rate increase request to 10.9 percent, which provided for a zero percent profit margin. In a brief filed in Superior Court, Anthem called the zero-percent profit margin unfair and unprecedented. In response to Anthem's lawsuit, Attorney General Janet Mills filed a 38-page brief two weeks ago detailing Anthem's revenues, profits and profit margins in Maine. Anthem, she said, can easily make a profit on the lower rate increase. In these tough economic times, she said the average individual policy holder pays about $6,000 in premiums each year, with deductibles of $7,250. "They want a guaranteed profit of a certain minimal amount on the backs of ratepayers who are carrying these health insurance plans, mainly small business owners, sole proprietors, restaurant owners, loggers, farmers – the backbone of our economy," Mills said Wednesday. Andrew Twaddle of Boothbay, a retired University of Missouri professor who attended the rally, said medical costs are bankrupting our society. "Since the early '90s, about 1.5 million people per year have lost health insurance in this country," said Twaddle, who said he spent 40 years studying health care systems around the world while teaching medical social programs and family community medicine. "What we have is the only developed country rapidly moving away from universal health care." Shanna Rogers, a 29-year-old restaurant manager from Lewiston, joined the protest with her three young sons. Rogers said she was four months' pregnant with identical twins when doctors diagnosed her with twin-to-twin transfusion syndrome, a disorder that causes one twin to receive more blood flow while the other receives too little. "First, (Anthem) denied the life-saving surgery. I won that appeal," Rogers said. "Then, after their birth, they denied the vaccine that would keep them out of the hospital with respiratory viruses, which is common for premies. Anthem won that time. "And then," she said, "last but not least, this fall, when they were diagnosed with speech and hearing problems, the speech therapist refused to bill Anthem directly because of Anthem's high denial of claims. I would need to pay for my services up front. "(The twins) are wonderful, sweet boys, and they wouldn't be here if Anthem had their way," she said. – The Kennebec Journal and The Associated Press contributed to this report.