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Blue Cross Trying to Hijack Health Reform in North Carolina

Jeremy Sprinkle
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State's largest insurer trying to seize control of health exchange

As North Carolina's largest health insurance provider - controlling over 96% of the individual insurance market and over 80% of the market for small businesses - Blue Cross Blue Shield of North Carolina had a huge financial stake at risk with passage last Spring of the Affordable Care Act. The health reform law mandated that states establish by 2014 a "Competitive Health Insurance Marketplace" or health benefits exchange to promote effective competition among insurance providers and offer a wide variety of insurance options.

Promoting competition by making it easy to compare insurance policies from different carriers while establishing strict standards for plans offered in the exchange - protections that would ensure these plans are a good value for consumers and small businesses - is not in Blue Cross' interest.

The health insurance giant is proving - as it did repeatedly during the protracted debate leading up to passage of the Affordable Care Act - that it cannot be trusted to do right by consumers, says Wendell Potter, a former insurance company executive turned whistle blower.

Here in Raleigh, Blue Cross Blue Shield of North Carolina (BCBSNC) -- by far the state's biggest insurer -- has helped draft a bill that would give the firm power to do the exact opposite of what Congress intended. If enacted, the bill would actually enable BCBSNC to control the exchange's ruling body, which could lead to a further reduction in competition and an undermining of efforts to help consumers make prudent choices when buying coverage.

House Bill 115 has been introduced in the NC General Assembly by Rep. Jerry Dockham from Davidson County, who until last year owned an insurance agency. Blue Cross denies that it has worked behind the scenes with Rep. Dockham to craft a bill friendly to the insurance company but says it supports the bill.

"It's like the fox guarding the hen house except in this case, the fox is dressed up in chicken suits," says small businessman Lou Meyers of Durham on insurers governing the new marketplace. "I mean it's just no win."

New health care coalition formed to fight Blue Cross power grab

Citizens for Responsible Health Care, a 9-group coalition of health care and consumer organizations of which we are one, held a press conference Wednesday in Raleigh to announce our opposition to HB 115:

To improve health care for North Carolinians, the state’s Health Insurance Marketplace must offer real choice that brings down costs for individuals and small businesses – and not simply be a tool of the insurance industry.

Any meaningful health insurance marketplace must abide by these two principles:

  1. Real competition and meaningful choice: plans offered in the marketplace the health exchange provides must meet strict standards, be easy to understand, have clear benefits, and offer good value.
  2. Credibility and independence: the exchange must be a tough, independent consumer watchdog. Because health insurers will be affected by almost every decision the exchange makes, insurance companies must not be allowed on the governing board.

Blue Cross wants to be that fox that guards the hen house. If HB 115 passes, health reform will die in North Carolina because accountability under the law begins with the Competitive Health Insurance Marketplace.

3 things you can do RIGHT NOW to stop Blue Cross

Don't let Blue Cross control the insurance marketplace in North Carolina. Immediate action is needed to stop HB 115 from becoming law. The bill will be up for consideration in a House committee on Tuesday.

  1. Write a letter to the editor of your local paperto stop Blue Cross from taking over health reform in North Carolina. We will give you the background material, but write your OWN letter in your OWN words. Click here to get started.
  2. Join our coalition for a competitive health insurance marketplace. Contact Abby Emanuelson ([email protected]; 919-­792-­1006) if your small business or organization wants to join Citizens for Responsible Health Care. Individuals can also join by sending Abby your information.
  3. Contact members of the House Health and Human Services Committee. Even if your Representative does not serve on the committee, contact the committee chairs. Here's the full list of committee members (and their county):

Background info on NC's Competitive Health Insurance Marketplace

Read Adam Linker’s Legislative Bulletin:  NC Needs an Open, Accountable, Pro-Consumer Health Benefits Exchange (opens PDF). Adam is a policy analyst for the NC Health Access Coalition, a project of the NC Justice Center.