February 6, 2008

            LANSING − Attorney General Mike Cox today, in testimony before the Senate Committee on Health Policy, said that a package of bills promoted by Blue Cross (HBs 5282-5285) is "deeply flawed."

            "Any reform package should focus on consumers first and Blue Cross second," Cox said.

            Cox called upon legislators to gather independent data before making any sweeping reforms, including a thorough audit of Blue Cross. Cox also urged lawmakers to mandate that OFIS, the Office of Financial and Insurance Services, in collaboration with groups such as AARP and the Area Agencies on Aging, create an annual 'Affordability Index' to keep track of health care costs and measure the impact of any changes to Michigan's health care system.

            Cox began by stating that the starting point for reform should be in response to three questions:

1. What is the state of Blue Cross?
2. What is the trend for those individuals who have to pay for their own insurance?
3. What is the state of individual health care costs in Michigan compared to other states?

            "Blue Cross controls more than 70% of Michigan's health insurance market, and its surplus has doubled since 2001 to $2.8 billion," Cox said. "Which begs the question: what problems are these bills solving?"   

            The effect of the four bills under consideration, Cox said, would be to:

• eliminate community rating and institute rate bands, so that health care consumers could be segregated by age and by community - otherwise known as redlining;
• allow Blue Cross to charge new customers with serious illnesses as much as 250% above their current premiums;
• enable Blue Cross to deny coverage for those who seek individual coverage on pre-existing conditions for up to twelve months; and,
• establish a hefty profit margin for Blue Cross, as high as 30%.

            Cox outlined eight areas for lawmakers to examine in connection with the changes being sought by Blue Cross. Those areas include the use of independent data; the use of workgroups to more fully understand the broad ramifications of proposed changes; restore the oversight by OFIS and the AG's office; examine the necessity of a high-risk pool and its ramifications; establish an 'Affordability Index' to measure the financial impact of any changes; re-examine the scope of any new loss ratios; provide more guidance on the use of reserves; and limit the scope of any new businesses to be purchased by Blue Cross.

            According to the American Health Insurance Plans Center for Policy and Research, Michigan has the fourth most-affordable insurance in individual markets. "That's one ranking Michigan should strive to keep," Cox noted.

            Cox noted that Blue Cross was created "to secure for all people of this state ... the opportunity for access to health care services at a fair and reasonable price," and that Blue Cross is a "charitable and benevolent institution."

            "Let us not forget the mission of Blue Cross is to put people over profits and not profits over people," Cox concluded.

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