The sick and expensive consumers are coming, so insurers are taking steps now to help guarantee they have plenty of healthy and inexpensive members to offset the new financial burden.
Insurers are appealing to their current individual members through letters highlighting upcoming changes in plans and ads urging members to keep their existing plans. Insurers hope these tactics will help boost the number of healthy members enrolled to counterbalance the additional costs expected with some new consumers who have chronic conditions, reported the Wall Street Journal.
"This is really about a panic in the insurance industry," Robert Laszewski, president of consulting company Health Policy and Strategy Associates, told the WSJ. "What they're gravely worried about is they won't get enough healthy people to pay for the costs of the sick people."
But some of these actions are running afoul of state laws. Kentucky officials, for example, called Humana's renewal letters for individual members "misleading intentionally" and fined the insurer $65,000. "This letter was preying on people's lack of knowledge about their consumer protections, their rights," Kentucky Insurance Commissioner Sharon Clark told the WSJ.
In Washington, two insurers' letters that failed to explain members can either switch companies or shop on the health insurance exchange led to the state insurance commissioner issuing a consumer alert. Premera Blue Cross and its subsidiary LifeWise Health Plan of Washington told members their current individual plans will be discontinued and urged them to choose another of their plans, the Seattle Times reported.
"Don't just take what your insurance company says, make sure you shop around," Washington Insurance Commissioner Mike Kreidler said in a consumer alert, according to the Seattle Post Intelligencer. "You have the right to buy any plan inside the new exchange or in the outside market."
But a spokesman for Premera and LifeWise told the WSJ most customers "are already well aware that there are other options ... without us having to spend time reminding them of that basic fact."