MHA's Friday Update Messages

MHA Friday Update Weekly Messages

Containing Costs for Consumers

June 23, 2017 By: Carmela Coyle

This week, the Maryland Insurance Administration held its public hearing on insurers’ requested premium rates for 2018 – requests that we believe are largely inaccurate and misleading.

The size of some insurers’ requests suggests a basic lack of understanding of Maryland’s unique health care system. For example, UnitedHealthCare attempts to justify an average 10-13 percent increase for its small group market by claiming there is a cost shift from public to private payers. This is a boilerplate, national argument commonly used to justify increases, but as we all know, Maryland’s All-Payer Model allows no such cost shift – and hasn’t for four decades.

MHA testified during Wednesday’s hearing and submitted a letter to the insurance administration outlining these and other concerns, namely that the filings:

  • ignore $230 million in fiscal year 2018 savings provided to insurers through the Health Services Cost Review Commission’s decision on shared savings with payers
  • use inaccurate hospital spending and utilization growth trends
  • do not demonstrate a commitment to maintain and improve the individual market, given its recent stabilization due to the influx of new enrollees beginning to level off

During the hearing, MHA testified that there is no indication of whether the nearly $350 million in shared savings to payers that has been generated under the All-Payer Model over the past two years are, in fact, being passed on to consumers. We also expressed concern that the submitted rate requests will make care less affordable and less accessible, pushing Marylanders to disenroll from coverage, and upending a fragile stability in the individual and small group markets.

That could jeopardize the All-Payer Model, because broad-based coverage is essential to making sure Marylanders receive the right care, at the right time, in the right setting.

The Maryland Insurance Administration will make its decision on rates sometime before the start of the rate year in January. In recent years, following MHA’s testimony, the administration has begun to examine HSCRC data on hospital spending to inform their decision. That needs to continue.

It would be  a sign that regulators are listening, and are willing to take the steps necessary to ensure that Maryland’s unique hospital payment system does more than save money for payers, but also provides real help for the Marylanders for whom health insurance should be a comfort, not a burden.