Printed in The Wall Street Journal
February 18, 2010
The Democrats and their media
allies have found a new insurance piñata: WellPoint
and its recent health-premium price increases in
California. This spat deserves more attention,
because its real lesson is what will happen to
health insurance costs around the country if
ObamaCare passes.
WellPoint's California unit,
Anthem Blue Cross, recently informed nearly 700,000
individual insurance customers of premium increases
of up to 39%. President Obama jumped on the
announcement, claiming in a pre-Superbowl TV
interview that the hikes were a "portrait of the
future if we don't do something now."
Health and Human Services
Secretary Kathleen Sebelius quickly piled on by
ordering a federal inquiry, claiming a company that
made "$2.7 billion in the last quarter of 2009"
could not "justify massive increases." Senate
Majority Leader Harry Reid ripped WellPoint and
other "greedy insurance companies that care more
about profits than people." And right on cue, House
baron Henry Waxman scheduled a hearing, where he
will not blow kisses.
He ought to subpoena California's
political class because Wellpoint's rate hikes are
the direct result of the Golden State's insurance
regulations—the kind that Democrats want to impose
on all 50 states. Under federal Cobra rules, the
unemployed are allowed to keep their job-related
health benefits for 18 to 36 months. California then
goes further and bars Anthem from dropping these
customers even after they have exhausted Cobra.
California also caps what Anthem can charge these
post-Cobra customers.
Most other states direct these
customers to high-risk pools that are partly
subsidized, but California requires the individual
market to absorb the customers and their costs. Even
as California insurers have had to keep insuring
these typically older and sicker patients, the
recession has driven many younger, healthier policy
holders to drop their insurance—leaving fewer
customers to fund a more expensive insurance pool.
This explains why Anthem lost $58
million in California on its post-Cobra customers in
2009. If WellPoint didn't raise premiums amid these
losses, it would soon be under assault from its
shareholders, if not out of business.
This episode is a preview of the
adverse selection that would happen nationwide if
ObamaCare passes. The Democratic bills would control
what insurers could charge and force them to take
all comers, regardless of health status. These
burdens were supposed to be made tolerable by
requiring all Americans to buy insurance or face a
penalty. Yet when this "individual mandate" proved
to be unpopular, Congress watered it down so that
younger customers would be able to pay the penalty
knowing they can wait until they're sick to pay the
more expensive premiums. The only way an insurer can
make up for these higher costs is to raise premiums.
This is precisely what WellPoint
predicted would happen when it released a detailed
actuarial study in October showing that insurance
costs would soar for millions of Americans under
ObamaCare. The White House hasn't forgotten that
study, or forgiven WellPoint for releasing it, which
may explain the force of its current attacks.
As for WellPoint's profits, $2.2
billion of WellPoint's $2.7 billion fourth-quarter
earnings came from the one-time sale of a
subsidiary. After one-time items, WellPoint earned
$2.92 billion last year, compared with $2.86 billion
a year earlier. Anthem's profit margins are in line
with its two largest nonprofit competitors in the
state; its net income on a per-member-per-month
basis in 2008 was $12.62, compared to Blue Shield's
$13.22 and Kaiser's $18.45.
Anthem last year hired an
independent actuarial firm that found its rates
sound and necessary. The company presented its
findings to California insurance commissioner Steve
Poizner last November, who had a month to review the
proposed increases and never objected. But recently
amid the White House campaign, Mr. Poizner has
joined the chorus claiming to be "skeptical" of the
increases and demanding that Anthem postpone them
while he conducts a review. Anthem has done so.
Mr. Poizner is a Republican
running for governor, which proves that health-care
political opportunism can be bipartisan.
This document is not intended to
be authoritative, and its accuracy is not
guaranteed. It is believed to be correct at the time
of its printing. Any questions about official
interpretations of the law should be directed to
legal counsel.