Kreidler and carriers are clashing over the question of how much capital is enough capital.

SEATTLE (AP) — Two large nonprofit health insurers in Washington state now have a total of more than $2 billion in surpluses, according to Mike Kreidler, the state’s insurance commissioner.

Premera Blue Cross and Regence BlueShield each has a surplus of more than $1 billion, according to filings for the first quarter. That’s more than what the companies are required to set aside in reserves, Kreidler said.

“They’re building up a financial cushion for themselves, and it comes at an expense for people,” Kreidler said. He said the insurers should use some of the surplus money to reduce rate increases for policyholders.

“These aren’t reserves,” Kreidler said. “They’re financial surpluses.”

Eric Earling, a spokesman for Premera Blue Cross, said the surplus money is needed to ensure that the company can pay claims and invest in new technology and service capabilities. Unlike private insurers, not-for-profit ones can’t sell stock or bonds to raise capital, so they need to set aside money, he added.

Premera also needs the surplus to handle the cost of implementing the Patient Protection and Affordable Care Act (PPACA), he said.

Premera has 1.5 million members in Washington and Alaska, and the money amounts to about $700 per member, Earling said.

In a statement, Regence BlueShield said its capital reserves provide a safety net for members against unknown risks and costs, and money needed to finance initiatives. Using cash from the surplus to lower rates would promote a false impression that health care costs are going down, the company said.

The cost of health insurance is going up because medical costs are going up, the company said.

Kreidler has been pushing to change state law so the insurance commissioner can take into account the size of insurers’ surpluses when considering whether to approve or deny premium rate hikes for individual and small group plans. Eleven states, including Oregon, give their insurance commissioners that authority, he said.

A state Senate bill that would have given Kreidler rate-approval authority did not get a floor vote during the legislative session that ended earlier this year. Insurers testified against the measure, saying carriers need to be financially strong in light of changes and uncertainties associated with PPACA.

Kreidler said he plans to support a similar bill next year.

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