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Life Health > Health Insurance

Potter to NAIC: Be a Hero to Consumers

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SEATTLE–A consumer watchdog told insurance commissioners here that consumers are looking to state regulators to protect them from health care companies’ tendency to put shareholders first.

Wendell Potter, a former insurance company executive who is now affiliated with the Center for Media and Democracy, Madison, Wis., addressed attendees at the National Association of Insurance Commissioners’ (NAIC’s) summer meeting Saturday.

“A lot of people are watching what you are doing here,” Potter said.

The decisions commissioners make regarding health care regulation will determine whether the public perceives the NAIC “as a champion for consumers” or as a champion for health insurance carriers,” Potter said.

Commissioners could decide Tuesday how to implement the new Patient Protection and Affordable Care (PPACA) minimum medical loss ratio (MLR) requirements, which will set the minimum amount of premium revenue going to medical care and quality improvement efforts at 80% for issuers of individual and small group coverage and 85% for issuers of large group coverage.

Potter, who was a public relations executive at a large health insurer before he began working with the CMD, said for-profit insurers will manipulate MLR figures to improve earnings and enhance shareholder value.

He called on the NAIC to keep the scope of the “medical cost” definition narrow.

Potter said commissioners should resist the pressure being exerted by Wall Street interests.

“You are the ultimate consumer representatives, and we trust that you will decide what is in their best interests and premium dollars will go to their needs,” Potter said.


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