Pennsylvania health-care advocates are looking for more transparency from the state Insurance Department and complaining about a rate increase granted to two companies in West and Central Pennsylvania.
When the state-sponsored AdultBasic program ended this year, thousands found coverage in the Special Care plans offered by the Blues insurance companies in Pennsylvania.
Now, the Insurance Department has approved a nearly 5 percent rate increase for those plans in western and central Pennsylvania.
“We took the public comments into our consideration in reviewing these rate applications–that did have an effect here–but what more a public hearing could do, we didn’t see the benefit there,” department spokeswoman Rosanne Placey said.
Premiums for the Special Care plan start at about $140 a month; on average, the approved 4.9 percent increase equates to about $8 more a month for members.
Highmark Blue Shield first asked for a 9.9 percent increase, but spokesman Michael Weinstein said the company lowered its request in response to community concerns. Critics say that change suggests that the rate increase is arbitrary, not based on cost analysis.
Weinstein says Highmark is facing fast-rising health-care expenses for the many hard-to-insure people in the Special Care plans.
“We anticipate that these programs will actually lose money. The rates that are being charged to individuals are actually about 25 percent less than what they would be if Highmark did not subsidize these programs,” he said.
Independence Blue Cross in the Philadelphia region did not ask for a rate increase for its Special Care plan. But starting in January, members will face a $50 co-payment for emergency room visits.