Check Out Our NEW WEBSITE!
We're very excited to invite you to check out our new website! It's fabulous -- we've added lots of new content on health insurance, employment issues, and education issues; we've archived our Newsletters so if you ever miss one, you can find it there; and we've made things a whole lot easier to find. So please check it out, browse, and drop me a note and tell me how you like it! We're still in the same place, but we have a brand spanking new look. I hope you like it -- and I hope it helps you to find the tools you need to be your own best advocate!
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| Know Your Rights Handbook |  |
Want to be your own advocate? Learn how by ordering the Know Your Rights Handbook today.
Learn about health and disability insurance, Social Security disability, employment discrimination, family and medical leave, school-based accommodations, resource location, and much more.
Click here for more information.
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Look What I Just Found!
I just found the Prepared Patient Forum, a project of the Center for Advancing Health. There is a TON of information about how to find doctors, relating with doctors, organizing your health care, paying for your care -- and on and on. There appears to be a wealth of information here that's very similar to the kind of advice I give people every day. In particular, check out the Prepared Patient 411, which provides resources and links for people looking for help, and the Be A Prepared Patient page, which helps to get the most out of your health care. So check it out and become a Prepared Patient today.
And here's a two-fer this month! One way to manage your care well is to keep good records. Well, here's the Care Organizer. It's a notebook that helps you organize and document your medical care. If you're having trouble keeping records on your own, check it out.
Jennifer
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Get Your Guts In Gear
Advocacy for Patients is a beneficiary of Get Your Guts in Gear's 2010 Rides. To learn more about the 2010 Rides in New York, Seattle, and the Midwest, and how you can participate as a rider or volunteer crew member, see their website for details or call 866-9IGOTGUTS (866-944-6848). |
Advocacy for Patients on the Move!
Nothing on our travel calendar for now; a little break is a good thing. We'll hit the road again in the Spring.
In the meantime, can we do a webinar for your organization? Contact Jennifer and we'll be happy to accommodate your request.!
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It's Too Hard to Be Sick in America
Our book, It's Too Hard to be Sick in America, is available FREE for your reading pleasure on our website. In it, we tell the stories of some of the patients with whom we've worked in order to show policymakers what chronic illness really looks like. Go have a read -- and the next time you talk to someone who clearly doesn't "get it," give them a copy of It's Too Hard to be Sick in America.
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Advocacy for Patients
with Chronic Illness We provide FREE information, advice and advocacy services to patients with chronic illnesses in areas including health and disability insurance, Social Security disability, employment discrimination, Family & Medical Leave Act, school-based discrimination, and resource location.
Need help?
Call (860) 674-1370
or email us.
Advocacy for Patients Needs Your Help!
To keep providing these services for FREE, we need your help.
WE DO NOT SOLICIT DONATIONS OUTSIDE OF THE FOLLOWING STATES:
CT, MA, WA, MN, CA, IL, NY, TX, VT, MT, ID, WY, NV, SD, NE, IA, IN.
Advocacy for Patients is committed to using its funds to support the work we do on behalf of patients. Accordingly, due to the cost of registering to solicit donations in other states, we do not solicit donations outside of the states listed above. Nevertheless, generous donors from many states make unsolicited donations for which we are very grateful.
THANK YOU!
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Happy Holidays!
Happy holidays to you and yours. We know the holidays will be tough for some of you this year who are struggling financially and medically. Remember that the holidays are not about big gifts and fancy dinners; what matters is family, friends, warmth, and health. We at Advocacy for Patients wish you all of that and more, and we are here to help you find resources to get you there if need be.
Peace,
Jennifer, Echo and Nicole, and our Board of Directors, Carole, Pasquale, Clay, Janis, Laura, Tom and Erica.
P.S. - Thanks to all of you who participated in this year's One Hour Challenge. You raised $4575 for Advocacy for Patients!!! We're very grateful.
P.P.S - And if you are in the gift-giving spirit, don't forget the Advocacy for Patients store. T-shirts, mugs, mouse pads, and of course our Handbook all ready for purchase and shipping today.
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Advocacy for Patients Testifies Against Anthem Blue Cross Rate Increases
As is the case in many states, Connecticut does not have a rigorous statutory scheme for reviewing and approving (or not) premium rate increases for health insurance. However, Connecticut has some of the highest insurance rates in the United States.
Last year, there was an effort to curtail Anthem's rate increases, which did result in some reduction in the requested increases. But since then, the federal government has given the Connecticut Insurance Department (CID) $1 million to beef up their rate review process. So this year, when CID agreed to hold a hearing on Anthem's rate, we looked at it as a new beginning, a chance to encourage the CID to beef up its process.
Let me say from the outset that, for us, this is not about Anthem. We would have testified -- indeed, we will testify -- in favor of greater transparency and public participation regardless of what insurer was seeking rate hikes. The point of our testimony was to try to encourage the CID to be more rigorous, ask more questions.
For example, Anthem's main argument was that health care utilization has increased, which increases their costs. Here's what we said:
Anthem's statements regarding health care utilization directly contradict widely-quoted statements by Anthem's parent corporation, WellPoint, Inc. Anthem states that "[h]ealth care costs and utilization are the two main drivers of increasing health insurance premiums." Anthem's actuarial analysis reveals that claims cost is growing at a rate of 12.5 percent.
However, WellPoint reported better than expected earnings in the third quarter of 2010 because health care utilization has decreased significantly. Wayne DeVeydt, chief financial officer of WellPoint, states that utilization has fallen as compared with last year for several reasons, including the expiration of COBRA benefits and lower flu-related expenses this year. Murphy, "Drop in care use boosts health insurer 3Q earnings," Washington Post (Nov. 3, 2010). See also Helfand, "WellPoint and Aetna post higher profit in 3rd quarter," Los Angeles Times (Nov. 4, 2010). "'People just aren't using health-care like they have,' said Wayne DeVeydt, WellPoint's chief financial officer, in an interview Wednesday. 'Utilization is lower than we expected. . . .'" Johnson, et al., "Americans Cut Back on Visits to Doctor," Wall St. Journal (July 29, 2010).
Thus, Anthem's basis for the majority of the requested rate increase is directly contradicted by WellPoint. Anthem should be required to explain this obvious discrepancy.
The CID asked Anthem about this discrepancy. They said they were using Connecticut utilization and costs, whereas WellPoint's figures were national. But the CID never asked the obvious follow up question: Why do Connecticut's consumers use health care at such a higher rate than in the rest of the country? Indeed, where's the proof that that's even the case?
We, the Office of the Healthcare Advocate, and the Attorney General's Office urged the CID to ask these and other searching questions. They didn't.
Indeed, there was a lot of discussion about whether it's legitimate for Anthem to take across-the-board rate increases on all plans, including HMOs, PPOs, and high deductible plans. There's no question, for example, that health care costs and utilization are far lower with high deductible plans because people can't afford the deductible. So why should premium increases for high deductible plans be the same as for HMOs and PPOs? No real answer.
Anthem did take a creative position that I found to be fascinating. They said that, under health reform, if their medical loss ratio -- the percentage of premium dollars that is spent on health care costs -- is not 80% or higher, they will have to give their members rebates. So it makes sense, they said, to err on the side of the premiums being too high rather than too low since insureds will get rebates if they're too high, but Anthem would have no recourse if they turned out to be too low.
The obvious response to this came in the form of moving testimony of consumers who explained that health care costs were crippling their small business, or were forcing them to drop their insurance entirely. For people who are squeezed out of the market because rates are too high, there will be no rebates. There will be nothing for them.
We concluded our comments as follows:
Above all else, rate filings should be striving for maximum transparency to allow for meaningful public participation. As we move into the post-reform era of rate review, the CID should require all insurers to provide affected insureds with notice of the rate filing and the date and time of the hearing, and ensure that their rate filings are sufficiently informative and detailed so as to allow the public to understand them. Here, Anthem has provided less information than even its own parent corporation recommends, and nowhere near as much as the many consumer groups that filed comments in response to the HHS notice would prefer. Anthem should be required to revise the filing to provide all of the information that WellPoint agrees should be included in rate filings.
The CID gave Anthem to November 29 to submit several pieces of additional information, after which the CID will render a decision. And while this hearing fell far short of where it should be to protect consumers and promote transparency, it may well serve as a model for the next Commissioner of what needs to be done differently. After all, a $1 million grant from the federal government to beef up rate review should result in clear and important improvements in the rate review process.
If you want to read our entire testimony, go here.
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Big News at Advocacy for Patients
As you can imagine, our caseload is absolutely exploding. Not only do more people learn about us every month, but there are many more people who are unemployed and uninsured and in need of any help they can get. Insurance companies seem to be cracking down, as well. We have more complex insurance appeals than ever before.
With that in mind, I'm thrilled to announce that Nicole Netkin-Collins will be joining our staff as our first full-time Staff Attorney starting in March 2011. Nicole has been with us on and off for a long time, first as a summer intern, then as a part-timer. She writes insurance appeals as well as I do, and she's as committed to the work as anybody I know.
Nicole graduates from University of Connecticut Law School in December, and will then take January and February off to study for the Bar exam, starting at Advocacy for Patients full-time in March.
This is a risk; our budget will have to grow to help pay Nicole. I hope you will keep that in mind when making your year-end charitable donations. Remember that, when you give to Advocacy for Patients, you literally save lives. If we've helped you before, and you can help us now, we sure would appreciate it.
I know that you will join me in welcoming Nicole in March after she takes the Bar exam. Something wonderful to look forward to.
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Advocacy for Patients Partners with Keiosk to Make Educational Videos
I'm excited to announce that Advocacy for Patients is partnering with Keiosk, an organization that uses video to help parents and families learn how to parent. Keiosk's Duane Pierre, a long-time videographer with a heart the size of Montana, started Keiosk to help parents find resources they need to be the best parents they can be. He's now added Advocacy for Patients to the Keiosk toolkit. Go here and then, under channels (on the right) or on demand (also on the right), choose Advocacy. There are two segments in which a very uncomfortable me (I hate having my picture taken) talks at length about how to seek accommodations in school. Future episodes will cover Family & Medical Leave and health insurance issues.
This is just the beginning of a beautiful friendship -- one that will bring you much of what's in our Know Your Rights Handbook on video, thanks to Duane's great video skills. I hope you'll watch and enjoy all that Keiosk has to offer.
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The Chronicity Project
This is the space in our newsletter where we talk about health care policy affecting the chronically ill.
Here's an update on what's happening in the legislative arenas:
Federal
While health reform implementation proceeds, there is now talk of repeal or, at the very least, amendments. We will try to keep you up to date on all of this, but it's going to get noisy, as many bills are introduced to eliminate or change many aspects of the reform legislation. Look for attempts to make the prohibition against using federal funding to pay for abortions -- a prohibition that's already in the law -- even stronger (although I don't see any gaps in it now). In addition, we've already seen a proposal that would allow States to opt out of the requirement that individuals purchase insurance as long as they meet a set of criteria that shows that they're dealing with the goal of universal coverage in other ways. I suspect that there will be many other proposals, many of which will be symbolic since the Republicans know they don't have the votes for repeal in the Senate, and the President would veto any bill that attempted to gut the law. If you like any of the benefits of reform -- if your child is now on your policy to age 26, or if your child to age 19 now has coverage of pre-existing conditions, if you are enrolled in the affordable pre-existing condition insurance plan, if you are looking forward to the new appeals rules giving you more muscle as you fight for coverage with your insurer, let your members of Congress know. They're likely to listen to the loudest voices, and right now, that's the opposition. So if you want reform to remain the law -- with tweaks to improve it -- contact your members of Congress today.
To find your Representative, go here; to find your Senator, go here.
Connecticut The Connecticut legislative session will get going soon. We'll continue to focus on SustiNet design and implementation (for more info, go here). The SustiNet Board has come up with several options for the new Governor to consider, from pooling all of the people who already are insured by the State of Connecticut (State employees, retirees, HUSKY members, etc.) to expanding that pool to include small businesses, nonprofits, municipalities, and even large groups. Since the budget deficit is a serious concern, look for incremental implementation. But since even just pooling would save the State many millions of dollars, expect to see some implementation of SustiNet in this legislative session. As always, it's always good to contact your State Senator or Representative and tell them how you feel about things. Your State
Is there something happening in your state's legislature? Shoot me an email and I'll add it to our next newsletter. In the meantime, keep up the fight. First, be aware. Read your local newspapers. Find the website for your state legislature. Read. Write your state legislators about things that concern you. One tool we like is the Kaiser Health News, to which you can subscribe for free. But don't just read: ACT. Go to hearings and testify. Tell your story. Put a real face on the healthcare crisis. |
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Jennifer C. Jaff, Esq.  Executive Director
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