Health insurance reform may be the law of the land, but health insurance companies like Regence of Oregon aren't done screwing over their members/policy-holders.
My wife and I have individual Regence plans. Mine is the Blue Selections Premier, which I succeeded in switching to last year after going through a horrendous battle with the Regence underwriting department over some minor health problems (a.k.a. "preexisting conditions").
Recently we both got a packet from Regence BlueCross BlueShield of Oregon informing us that as of July 1 we'd need to switch to new plans, as our current plans will no longer be available.
Naturally our first thought was, "We're going to get screwed. The new policies are going to cost more and cover less."
Right on. Regence provided a comparison of my old plan and the new "Evolve Plus" plan that comes closest to what I have now.
Download Regence of Oregon new plan comparison
I'm going to pay $512 a month for the Evolve Plus, a bit more than the premium for my current $485 Premier plan. But the Evolve benefits have devolved downward, considerably. Here's an example:
Now there's a $500 deductible on brand name prescriptions, compared to no deductible before. Also, there is a $4,500 a year maximum prescription drug benefit, compared to no limit before. If someone is on expensive drugs for a serious condition, $4,500 will be used up quickly.
The basic Evolve plan, which my wife is to be switched to, is even worse: it has only a $1,000 maximum for all drugs. That's ridiculous.
It's impossible to compare the cost of the new and old plans, because the benefits have changed so much. This likely is one reason Regence is switching its individual policy holders over to the Evolve plans: instead of announcing another double-digit rate increase, Regence is keeping rates about the same and decreasing the value of benefits by double-digits.
Over on Blue Oregon I commented on a post about a proposal for an Oregon health insurance exchange.
This sounds like a good idea. My wife and I have individual plans from Regence Blue Cross of Oregon. Recently we, like many others, received a packet notifying us that our plans will be terminated July 1 and we'll have to choose from the new Regence offerings they suggested.
Which offer considerably reduced benefits, albeit at roughly the same cost as our premium now. This, of course, means that Regence has raised its premium price, but not in an open and transparent manner. It's impossible to figure out how much more it will cost us out of pocket because Regence has reduced its benefit package.
Being in our early 60s with pre-existing conditions (who has been perfectly healthy all of his/her life?) we can't change to another health insurance company. I believe the health care reform provision prohibiting discrimination on the basis of pre-existing conditions doesn't kick in until 2014 or thereabouts. So Regence has us and tens of thousands of other individual policy-holders over a "take it or leave it" barrel.
No competition. No free market. The proposal laid out in this post would be a heck of a lot better, especially if the marketplace included a true "public option" run by the state of Oregon.
Last gripe about Regence: their informational materials about the new plans say there is a $2 million lifetime cap on benefits. But this is one of the provisions of the health care reform bill that kicks up immediately -- no more lifetime caps. I've emailed Regence and asked why they aren't complying with the law of the land. Seems crazy that new health insurance policies issued after passage of the bill don't reflect its provisions.
Today I called Regence and asked about the $2 million lifetime cap. I was told that Regence is complying with the health insurance reform bill and will implement its provisions as required.
OK. I didn't really expect that Regence would ignore the law. But it seems to be doing its best to get around it.
There no longer can be a lifetime cap on health insurance policies written after September 23, 2010. Existing policies with caps will change to the new "no cap" rule at renewal time.
So if we'd been able to stay on our current Regence plans, the $2 million lifetime cap limitation seemingly would have been removed on July 1, 2010 -- our renewal date. But Regence has chosen to force all of its individual policy holders to change to a new plan on July 1. Which obviously is before September 23.
How convenient. For Regence of Oregon.
Because now it looks like the lifetime cap will remain in place until July 1, 2011, which gives Regence a whole year during which it can tell members who have an expensive serious illness, "Tough. You've used up your $2 million. Better get going on your garage sale -- or bankruptcy plan."
Health insurance companies have a horrible P.R. problem. I don't know anyone, not a single person, who has good things to say about the health insurance industry. Like I said, when we got the mailing from Regence our first (and also last) reaction was:
This has got to be bad news. We're getting screwed. Regence never does anything that benefits its members or health care providers; it only cares about its own profit margin.
There's only one real solution to the problems health insurance companies cause: get rid of them. Or at least heavily regulate them. The reform legislation that's been passed does neither, unfortunately.
That's why I'm on the opposite side of the Republican mantra, "Repeal and replace."
No, we've got to keep what we have and make it much stronger. If insurance companies like Regence persist in playing their selfish corporate games at the expense of their policy holders, pressure will build for that to happen.