Maine Health Insurance Premium Case Goes to High Court
Bangor, Maine – Maine health insurance company Anthem and the state Bureau of Insurance (http://www.maine.gov/pfr/insurance/) are engaged in a long-running battle over health insurance premiums. Anthem would like the right to a larger profit and risk margin, while the Bureau is exercising its authority to keep health insurance premiums affordable.
Maine’s highest court will decide the outcome which will directly affect health insurance premiums for about 11,000 Maine residents who use Anthem as their health insurance provider because their place of employment doesn’t provide health insurance benefits.
Although the Bureau of Insurance can’t dictate the health insurance premiums for local businesses, it can regulate rates for individuals, some of whom, for example, pay $500 a month for a $2,500 deductible, which is outrageous. Lowering the cost for health insurance in Maine is the overall goal.
Former Maine Superintendent of Insurance in the past had reduced the health insurance company’s proposed profit and risk margin because customers aren’t able to keep up with the premium increases. Currently, Anthem is the only health insurance company that provides individual health insurance benefits state-wide.
Health insurance companies currently stand unregulated, subject to market demands. The Affordable Care Act will change this slightly, giving the state and federal governments to conduct state reviews if it appears as though the health insurance companies are increasing their rates by more than 10 per cent a year, and if they are using less than 80 per cent of their profits from premiums on claims.
The state of Maine is asking that the Bureau of Insurance review the rate changes so that individuals who have to face these rate hikes have competitive prices elsewhere.
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Maine Health Exchange Criticized
The Maine Public Broadcasting Network (http://www.mpbn.net ) reported that the health care exchange proposed nicknamed “Obamacare” is receiving harsh criticism of its requirements under federal law for all Americans to have health insurance, with health insurance companies in Maine to be up-and-running by 2015. Maine Governor said he worries that this will require too much oversight from the government. Maine is only one of 26 states opposing the legislation.
The Affordable Care Act (http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act) envisions a marketplace wherein people can shop for health insurance coverage within certain limitations that are supposed to encourage reduced prices and competitive costs. These health insurance companies need to be self-sustainable by 2015.
The Supreme Court has agreed to hear the case to determine whether a) it is unconstitutional and b) if all 450 sections of the law need to be thrown out.
The goals of the Affordable Care Act are to provide one million more Americans with coverage, and ensure that the health insurance companies spend their consumers’ premium money on health insurance and not bonuses and advances.
Critics say individuals cannot be forced to buy insurance they may not want or need. The Justice department said that every American will participate in the healthcare market in their lifetimes, and that people do not choose to join it. Federal officials said that in 2008, uncompensated health care bills cost $43 billion for people who received health services without health insurance.
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