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(Augusta) Consumers
for Affordable Health Care (CAHC), the largest consumer health care
advocacy organization in Maine, is a Party-In-Interest at an oral
argument before the Maine Supreme Judicial Court. Anthem is
appealing the Maine Bureau of Insurance's 2011 decision that reduced
its demand for a guaranteed 3% profit - over $2 million in 2011 - every
year to 1% - about $650,000. Anthem believes that the law
requires the Superintendent to guarantee insurance companies in the
individual market whatever profit margin they propose. CAHC is a party
to the appeal, along with the Maine Bureau of Insurance (BoI) and Maine
Attorney General's Office. On August 29, Maine Superior Court
Chief Justice Thomas Humphrey upheld the Bureau's 2011 decision.
This is the second consecutive year Anthem has appealed its case to the
Court. In May 2011, the Court dismissed their 2010 rate appeal as
"moot" because the rate review increase they sought was for
the previous year and had already been eclipsed by a new rate.
The oral arguments of this hearing are scheduled to begin at 3:10 at
the Penobscot Judicial Center (78 Exchange Street) in Bangor.
There is no set time frame for the Supreme Court to render a decision.
In May then-BoI
Superintendent Mila Kofman granted a rate increase of 5.2% for Anthem
in the individual market. Anthem had requested an increase of
9.7%. The decision helped to save Anthem policyholders nearly $3
million. CAHC was a very active participant during the public
hearings for Anthem's rate review case, sending staff attorney Andrea
Irwin to each hearing to advocate on behalf of consumer interests and
Anthem policyholders. CAHC also hired its own actuarial experts
to testify on behalf of consumers at the rate hearing.
"The rate review
process, which has been under attack by the insurance industry, has
proven to be a critical tool in creating savings for policyholders
throughout Maine. The benefits in savings far outweigh the costs
of the review. In this case alone, Anthem policyholders will save
$3 million that otherwise would have gone towards Anthem's
profits," said CAHC Executive Director Joseph Ditré. "In
fact, the new health insurance law - Public Law, Chapter 90 - which
went into effect in September, will no longer require insurance companies
to undergo the rate review process if their request is under 10%."
State Representative Anne
Graham has introduced legislation that would appeal that language in
the bill, restoring the practice of rate review hearings regardless of
the premium rate increase. Last week the State Legislative
Council comprised of State House and Senate Leadership of both parties
voted not to consider Graham's bill this upcoming legislative
session. Representative Graham has said she is likely to appeal
their decision.
To view CAHC's brief to the
Supreme Court, please click here.
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