Color me shocked. Even Google was flummoxed. When I typed into the search engine 'Aetna rate decrease', Google kept insisting you mean 'Aetna Rate increase'.
It's being reported in the Hartford Courant that Aetna has asked the Connecticut Insurance Commissioner for permission to cut rates 10% for about 15,000 Connecticut customers.
This is a direct result of the Affordable Care Act and the MLR (medical loss ratio) rule. Beginning this year, as a result of the health care reform law, insurers will have to maintain medical loss ratios of at least 80 percent. This means health plans must use 80% of premium dollars in individual and small group plans on medical care (85% in large groups) or rebate the difference to its policy holder victims.
Here's what you must understand about all this. The reason Aetna has the money to request this rate revision is because it has been able to amass a fortune by avoiding paying for care by moving their policyholders into high-deductible plans and spending far less on medical care—and far more on overhead—than they have in the past. The CEO of Aetna, Ronald Williams received the highest compensation of all the health insurance CEOs for orchestrating this deadly charade.
How much insurance firms spend on medical care is measured by what is called the medical loss ratio.
In 1993, the average medical loss ratio in the health insurance industry was 95 percent, which meant that insurers spent 95 cents out of every dollar they collected in premiums on medical care. In their quest for profits, all insurers have been spending less on care in recent years. The average medical loss ratio is now closer to 80 percent.
Of course, we know why people are using less medical care. It's due to cost shifting and making high deductible junk insurance the only 'affordable' option for countless millions. The headline from the New York Times, Health Insurers Making Record Profits as Many Postpone Care explains it all. We're postponing care, because we can't afford to pay for the care.
Amid high unemployment and a weak economy, employers have been shifting health care costs to workers--what does this mean? It means that we're all paying a lot more and getting a lot less.
We're paying higher deductibles, co-pays and co-insurance, hence many of us are thinking long and hard before utilizing healthcare services. Is there any wonder why insurers are raking in profits hand over fist? When you and I are required to pay what is called 'the first dollar of coverage', that is, when we're facing a $2000 or greater deductible, chances are we won't use much healthcare, unless we're on the verge of death. We dutifully pay the monthly premium but rarely, if ever get healthcare. Our premium dollars represent pure profit to this rapacious industry.
So what do the thugs at Aetna have to say?This is what the Aetna spokesperson said:
"This is really about a good experience on this block of business, and the ability to be able to go back in and say, 'We can make our rates more competitive, we can deliver value back to the consumer, and we can let people put this money back in their own pockets,'" Millerick said.
This 'block of business' was undoubtedly high deductible junk insurance, requiring the policyholder to pay the first dollar of coverage. High deductible junk insurance is also called catastrophic insurance, it's supposed to spare you from going bankrupt if you are faced with a serious medical problem. Some of these junk insurance plans pay for a single preventative visit, many don't. So, end of the day, you're on your own.
If I'm not mistaken, when the Affordable Care Act is fully implemented in 2014, even the bronze plan (the cheapest) with the lowest actuarial value and the highest cost-sharing, will require insurers to pay for some preventative care.
Until then, stay healthy.