VPR | July 25, 2017

Should Vermonters Pay $50 Million More In Health Insurance Premiums? Regulators To Decide

State regulators will have to weigh conflicting testimony as they decide whether to approve a proposal that would increase Vermonters’ health insurance premiums by more than $50 million next year. 

Blue Cross and Blue Shield of Vermont, the state’s largest private health insurance company, is seeking asking the Green Mountain Care Board to approve a 12.6 percent increase in health insurance premiums.

Whether or not that rate increase is warranted depends on who you talk to.

According to Mike Fisher, chief of the Office of the Health Care Advocate, the request well overshoots the amount of money Blue Cross will need in 2018 to cover its policyholders health care expenses.

“Our expert witness evaluated the entire filing from Blue Cross and found four areas where we thought their predictions were too high,” Fisher says.

Fisher’s state-funded office was created to protect consumer interests in Vermont’s nearly $6 billion medical industry, and it hired an independent actuary to vet Blue Cross’ proposed rate.

Fisher says Blue Cross assumes higher utilization trends in 2016 will continue unabated, a conclusion his office now challenges. Fisher also says Blue Cross has overestimated the impact of Vermont’s aging population on overall health care expenditures that will be incurred by Blue Cross’ policyholders.

“And ultimately, [we] recommended to the Green Mountain Care Board that Blue Cross’ proposal was about 4 percent too high,” Fisher says.

That 4 percent translates into real money.

Blue Cross’ proposal would increase Vermonters’ premiums by more than $50 million next year. If the Green Mountain Care Board sides with Fisher’s office, then than number would drop by about $15 million.

But that’s only if they side with the Office of the Health Care Advocate. And Sara Teachout, director of public relations at Blue Cross, says the weight of the evidence lies in favor of Blue Cross. [...]