| Offices : Beckley • Charleston • Fairmont • Martinsburg • Washington, DC | E-mail Senator Rockefeller |
September 9, 2009
Bringing Accountability to the Health Insurance Industry
By: Senator Jay Rockefeller
So many people have been there – you get a letter from your health insurance company saying you owe a significant amount for care you or a family member recently received. Maybe it says your claim is being denied because of a pre-existing condition, you’re being charged what seem to be excessive co-pays, or you’re being denied full coverage because you saw an “out-of-network” doctor.
You try to read the fine print, to understand the fees and what they really mean. You give your insurance company a call, hoping that someone on the other line can clear things up – but you’re given the runaround, and hang up feeling even more confused, frustrated and angry.
You worry you’re being ripped off. And as we recently heard in the Senate Commerce Committee from testimony by Wendell Potter, who worked in the insurance industry for more than 20 years – you probably are.
Mr. Potter explained very clearly the tactics insurance companies use to keep policyholders in the dark. He said they deceive consumers through incomprehensible explanations of their benefits, often leading people to simply ignore them or throw them away.
He also said that more and more consumers are falling victim to deceptive marketing practices – which essentially encourage them to purchase policies with high costs and limited benefits.
Families who have paid their premiums faithfully every month for years expecting to be covered suddenly find themselves stuck with devastatingly high bills when they get sick. Their plans don’t actually provide coverage when they need it. It makes you wonder what the purpose of that health insurance is, in the first place, if it offers no protection against the ruin they hoped to avoid.
And he told us that his former employer, CIGNA, and other insurance companies, would “purge” small businesses whose employees made too many claims. Essentially, if an employee had a serious illness one year they would increase the premiums so high the next year that the company would have to drop the coverage.
As I hear from West Virginians every single day, deceptive insurance industry practices are hurting people – and they’re harming every sector of our economy. At a recent health care forum in Charleston, a small business owner told me the cost of providing coverage to his employees has doubled in the past five years.
In the face of soaring costs, we have to help people like him provide coverage for his employees with tools like tax credits. But more importantly, as part of truly meaningful health care reform, insurance companies must also act responsibly.
When insurance companies mislead their customers and don’t give them real choices – when they flat-out fail to meet their obligations – it can literally become a matter of life and death.
That’s why since March, I’ve been holding a series of hearings in the Commerce Committee to get to the bottom of these misleading practices, and demanding explanations from companies like CIGNA. And it’s why I wholeheartedly believe that holding insurance companies accountable for their actions has to be at the heart of any true health care reform.
Insurance companies have seen their profits soar over 400 percent since 2001, while premiums for consumers have doubled. Right now, the insurance industry is profit-driven when it should be patient-driven.
They’re unfairly raising prices, cutting people out of coverage for pre-existing conditions, and as one report I released through the Committee revealed, systematically overcharging consumers who choose to see doctors outside of their networks.
To fight back, I have introduced the Consumers Health Care Act. In addition to creating a strong public health insurance option that would put competitive pressure on insurance companies and help drive down costs, my legislation also creates America’s Health Insurance Trust – created for consumers and run by consumers.
This Trust would have a consumer board that ranks insurance companies every year based on factors such as affordability and how they treat enrollees. And that’s exactly how it should be – you should know what you’re getting when you buy health insurance.
Doing nothing about our broken health care system is not an option. And I will continue fighting for tougher insurance regulation and greater transparency to protect families and businesses across West Virginia.
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