Methinks thou dost protest too much
A couple of days ago I reported on a bill Republicans have introduced that requires health insurance providers to tell you what part of your health insurance premium is the result of the Affordable Care Act. As wrote in the piece, this bill requires boilerplate language that the insurance companies must use that says “This portion of the premium is attributable to the federal Patient Protection and Affordable Care Act and not the enactment of any laws, rules, or regulations of the Michigan Governor, the Michigan legislature, or Michigan’s Department of Insurance and Financial Services.”. This language is proscribed, the word “shall” is used in the bill.
After publishing it, I got an email with the subject line “Blog post correction” from John Whetstone, the Deputy Director, Communications for the House Republican Caucus telling me that I had it all wrong:
Rep. Shirkey’s bill actually does require health insurers to list any cost-savings attributable to the ACA. In fact, the committee adopted a bill substitute to address concerns raised by Democrats. House Democrats were concerned the bill, as-introduced, wouldn’t allow cost savings resulting from the ACA to be disclosed to consumers, so the bill was reworded to make it clear.
Under the old bill, insurers would have been required to disclose the “amount or percentage” of the premium “attributable to the ACA.” Under the new substitute bill, insurers now have to disclose an estimate of the “impact” of the ACA on policy premiums. The key word is “impact.” So if the impact of the ACA is a decrease in premiums, insurers will have to show this on the policy statement, just as they will any premium increases attributable to the ACA.
If you would, please update the post to reflect this information. Also, please let me know if you have any questions.
Deputy Director, Communications
House Republican Caucus
Michigan House of Representatives
I wrote back to him:
That’s an interesting read of that language. So, if the cost of the premium has been lowered or stays the same, why would the insurer be required (the word “shall” is used) to include language that says “This portion of the premium is attributable to the federal Patient Protection and Affordable Care Act and not the enactment of any laws, rules, or regulations of the Michigan governor, the Michigan legislature, or Michigan’s Department if Insurance and Financial Services”?
If that were the case, why isn’t there a requirement to have similar language that says something along the lines of “This premium has been lowered by X percent due to the PPACA” or “This premium has not been impacted by the PPACA”. In other words, why doesn’t the bill take into account any other scenario other than an increase in premiums?
Unless the Detroit Free Press has reported this incorrectly, Democrats attempted to introduce such an amendment and it was voted down by Republicans. Why do that if they, in fact, supported the idea?
Mr. Whetstone is correct in that the original bill specifically called out “increases” and this was removed. Specifically, it said that insurers “shall provide a written estimate as to the amount or percentage of any premium increase that is attributable to the Patient Protection and Affordable Care Act” and the language they would have been required to use was “These increases are due to the federal Patient Protection and Affordable Care Act and not the enactment of any laws, rules, or regulations of the Michigan governor, the Michigan legislature, or the department of insurance and financial services.”
However, I contend that the language in new version still allows for no flexibility for rates that decrease or remain the same. This legislation is specifically geared toward increases in premiums and give the insurers free rein to assign whatever increases that arise to the ACA, whether the ACA was the reason or not.
The fact is that insurance premiums rise every year already. As I have pointed out before, these increases have gone down under President Obama. This week we learned that the average increase in insurance costs last year was the lowest in decades:
Health care spending is growing at the slowest rate on record, and health-care price inflation is at its lowest rate in 50 years, according to a report released Wednesday by the White House’s Council of Economic Advisers.
Specifically, since 2010, the year the Affordable Care Act (ACA) passed, the growth of health-care spending has averaged an estimated 1.3 percent per year. And price inflation for health-care goods and services is running at just 1 percent, year-over-year, the lowest level since 1962.
I spoke with Democratic Representative Kate Segal, the vice chair of the Insurance committee, and asked her if I was reading this correctly. She agreed that I was. This bill focuses only on increases, she told me, and, more specifically, doesn’t let people know about added benefits they are receiving like free wellness checkups and preventative care that are designed to help people lead healthier lives as well as coverage for things like birth control. (This was included in the Democrats’ amendment that I mentioned in my response to Mr. Whetstone.)
Further, she pointed out the hypocrisy in the Republican’s bill. “The requirements in the initial bill would have put an enormous burden on insurance companies to generate the data,” she said. “If you look at Blue Cross Blue Shield, for example, they have hundreds, probably thousands of plans that they offer and they would have been required to analyze every one of them. Rep. Tom Cochran introduced an amendment that would have required the insurance companies to disclose how much of your premium increase was due to the addition of this unfunded mandate. That was, of course, voted down.”
I updated my previous post to include this clarification regarding Eclectablogger Amy Lynn Smith’s pleasant surprise to find out that her insurance costs will go down by nearly $10,000 per year, thanks to the ACA and being able to purchase a new plan on the exchanges which she wrote about in her now-viral post:
I should clarify that Amy’s savings of $10,000 annually thanks to the ACA is due to her purchasing a new health care policy from her insurer, not because her current policy went down in cost. That almost never happens. It was only because she was able to purchase it through the exchange as part of a larger pool of insurance buyers that she was able to save so much money and she has the ACA to thank for that.
As everyone knows, health insurance premiums on average have gone in cost up every year for decades. As I have pointed out in the past, the rate at which they have gone up has actually decreased under President Obama, but they still go up thanks to inflation, the rising cost of health care, and profit-taking by insurance companies. This is the most diabolical part of this legislation actually: almost no insurance premium EVER goes down, before the ACA or otherwise. So all HB 4816 does is focus on policies that people keep from year to year which almost invariably rise in cost.
Mr. Whetstone’s contention that the change in wording to use the word “impact” instead of “percentage increase” absolves them of what is a blatant political move to try to cast the ACA in the most negative way possible doesn’t pass muster. The proscribed boilerplate language still forces them to point to the part of your premium that was “impacted”. However, if you premium didn’t go up or, in fact, went down, there would be nothing to point to and the language they require doesn’t allow for that.
It’s anti-ACA politics and nothing more.
In his final email to me, Mr. Whetstone said, “I again point to the wording of the legislation. The language does require insurers to show potential decreases in premiums due to the ACA but I have a feeling that I’m not going to be able to convince you of that fact.” I would agree, particularly after my discussion with Rep. Segal.
More, to the point, I would say he never really tried.
It’s nice to know they’re paying attention to our work here, though.