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Blue Cross Pressed to Justify CA Rate Hike



LOS ANGELES (AP) - Over the past 12 years, Josh Libresco's health insurance premium has increased almost eight-fold for his family of four.

The 54-year-old San Rafael resident is facing a 39 percent rate hike from Anthem Blue Cross on March 1 that will raise his premium from $858 to $1,192 a month. In 1998, his monthly premium was $151.

Libresco was one of a number of Anthem policyholders who received a letter last week saying California's largest for-profit health insurer plans to hike premiums on individual policies by 30 to 39 percent.

Anthem has declined to say how many of its 800,000 individual policyholders in California are being affected by the hike. But Health and Human Services Secretary Kathleen Sebelius demanded specifics in a sternly worded letter Monday, saying the insurer has "a responsibility to provide a detailed justification for these rate increases."

In a surprise appearance at Tuesday's White House briefing, President Barack Obama criticized the Anthem rate hike for the second time this week, urging Congress to take up health care reform in earnest.

"If we don't act, this is just a preview of coming attractions: Premiums will continue to rise for folks with insurance, millions more will lose their coverage altogether, our deficits will continue to grow larger," said Obama. "And we have an obligation - both parties - to tackle this issue in a serious way."

Anthem did not have immediate response to Obama's comments. In a statement Monday, the insurer blamed the weak economy and rising health care costs for its rate hike, while pledging to reply to Sebelius' query promptly.

Health insurance analysts agreed that the rise in individual premiums will be echoed on a smaller scale in the rest of the marketplace. Employer-based insurance and group policies will likely see 10 to 20 percent increases in the next year, said health industry consultant Robert Laszewski.

About 13 million Americans purchased health insurance through the individual market in 2008, the most recent data available. Surges in their premiums can be explained by competing interests: Insurance companies are working to maintain earnings expectations in the face of rising costs, while rising premiums are driving healthy people to drop coverage, Laszewski said.

Various insurers have mandated rate hikes on individual policies across the country in recent years, though California's increase is larger than most. Last month, Anthem Blue Cross and Blue Shield filed for a 23 percent rate hike on 11,066 individual policies in Maine. In November, Oregonians holding individual policies with Health Net Health Plan of Oregon faced a 22.8 percent hike.

In a rare move, California Insurance Commissioner Steve Poizner is hiring an outside actuary to determine whether Anthem is abiding by state regulations and spending at least 70 percent of premium dollars on medical care as opposed to administrative costs.

Poizner's spokesman, Darrel Ng, said that's the only recourse because rate hikes do not need to be approved by the state.

After receiving numerous complaints from "irate Californians," Poizner asked the insurer in a letter Monday to delay implementing the rate hike for two months, until the actuary completes his review.

Anthem officials had no comment, saying the letter was being reviewed Monday.

The Los Angeles Times first reported the California rate hikes last week. Anthem notified customers that rates would go up beginning March 1 and might start increasing more frequently than the usual annual increases. The company declined to provide details on the rate increases, such as how many people would be affected or how much the new rates would be.

It's also not clear whether customers in other states are being affected.

Indianapolis-based WellPoint is the largest commercial health insurer based on membership. It operates Blue Cross Blue Shield plans in 14 states and Unicare plans in several others.


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