January 15, 2002

 

LETTER TO THE EDITOR

 

DOES THE CAREFIRST CONVERSION AND SALE BENEFIT MARYLANDERS ?

 

 

In November 2001, CareFirst, the state’s largest health insurer of 3 million people, announced its intention to convert from its nonprofit status to a for-profit insurer and sell itself to WellPoint Health Network for $1.3 million.

 

The reaction to the plan by the State’s Hospital Association, medical societies, health care advocacy groups, the general public and the Maryland General Assembly was swift and overwhelmingly negative.   The Assembly sentiment was summed up by then-House Speaker Casper R. Taylor, who stated publicly, “Blue Cross is our historic insurer of last resort.  There is a strong feeling in the Legislature that they (CareFirst) need to be brought back to their mission.”

 

Although a nonprofit insurer, CareFirst’s business practices over the past several years have more closely resembled those of a commercial insurer.   CareFirst has jettisoned its unprofitable Medicaid and Medicare HMO programs.   This move left thousands of poor and sick Marylanders without health coverage and thousands of seniors without prescription drug coverage.

 

CareFirst has twice requested, and twice been denied, huge monthly premium hikes – as much as 247% - in its open enrollment program for over 5,000 high health risk individuals who cannot obtain health coverage at an affordable cost.  In July 2003, the open enrollment plan will be replaced by a state-run high-risk pool, similar to pools already operating in 30 states.

 

In May 2001, CareFirst withdrew its subsidiary HMOs, FreeState and Delmarva, from both individual and small group insurance markets in Maryland.   In a letter to legislative leaders, Insurance Commissioner Steven Larsen stated that in dropping its FreeState HMO policies, CareFirst was trying to improve profits “at the expense of thousands of less healthy former FreeState members.”

 

The Legislative slow burn over CareFirst’s conduct erupted during the 2002 session.   Legislation, backed by House and Senate leadership, was approved to significantly hamstring the deal.   One measure, now law, gave the General Assembly the final word on the CareFirst conversion and sale.   No matter how Commissioner Larson rules on the deal, the General Assembly will determine whether it sails or sinks.

 

 

 

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In March 2002, fuel was added to the fire.   The extent to which the CareFirst CEO, William L. Jews, and his executives would benefit from the conversion and sale was revealed.   Jews, who warns a $2.7 million annual salary, stands to collect $39.4 million in bonuses, severance and tax benefits.   Another $80 million would be split among other CareFirst executives.   Although the 2002 Assembly passed law prohibiting executives from obtaining merger bonuses and incentives, the CareFirst Board approved the gigantic payout package before the law became effective.

 

CareFirst continues to claim that its conversion and sale to WellPoint will benefit Marylanders by providing more accessible and affordable health insurance.   Frankly, I don’t believe that a for-profit CareFirst, owned by WellPoint, a corporation based in another state, will improve the quality or cost of health care and health care coverage for Marylanders.

 

It’s worth noting that CareFirst currently spends 88% of its premium dollar on actual health care.   By comparison, WellPoint spends 75% of its premium dollar on actual health care.   Certainly, we would be foolish to believe that as a member of the for-profit WellPoint network, the percentage of CareFirst’s premium dollar spent on health care will increase or even remain the same. Additionally, I am very concerned that WellPoint refused to give Insurance Commissioner Larsen any information about its underwriting or pricing policies, by which its insurance coverage and premiums are decided. Therefore, we do not have the information we need to make valid comparisons with CareFirst’s policies.

 

CareFirst CEO Jews defends the size of the bonuses and incentives, declaring that they “pale relative to the opportunity to help people.”   I don’t buy it.   If the sale to WellPoint goes through, millions will be paid to high-salaried executives that would be better spent on providing health care coverage to the uninsured and reduced premiums for the insured.    The total payout of $119.6 million to the CEO and other CareFirst executives would be enough to pay for one year’s health insurance for 36,000 Maryland families.   Let’s face it, both the CareFirst salaries and the proposed merger bonuses and incentives are more in keeping with a Fortune 500 Corporation than a non-profit enterprise.

 

The 1937 General Assembly, which issued a charter to Blue Cross to operate as a nonprofit insurer of last resort, would not recognize the CareFirst BlueCross BlueShield of today.  The Blues of today have become an insurer more focused on profit, than providing affordable health insurance to the greatest possible number of Marylanders.

 

I can see no benefit to the people of Maryland from the conversion of CareFirst to a for-profit status and its sale to WellPoint.   Marylanders would be better served if CareFirst is legally required to return to its original mission as a viable nonprofit insurer and the state’s insurer of last resort.

 

When the matter reaches the House Health Committee, on which I serve, and the full House of Delegates, I will vote against the CareFirst conversion and sale.

 

Sincerely,

 

 

Eric Bromwell

 

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