Michigan has the fourth least competitive health insurance market in the country, meaning consumers and employers have fewer choices for health insurance than in most other states, according to a report by the American Medical Association.
Only Alabama, Alaska and Delaware had worse markets for health insurance competition, according to the report that used 2009 enrollment in health maintenance organizations and preferred provider organizations from 368 metropolitan areas and 48 states to come up with its findings.
In Michigan, the nonprofit Blue Cross Blue Shield of Michigan — the state's insurer of last resort — controls 71 percent of the state's commercial health insurance market, the association found.
The Blues control two-thirds or more of the commercial health insurance market in 13 of 15 metro areas surveyed across the state. In the Jackson area, the Blues had an 85 percent market share, marking the state's least competitive health insurance market, the report said.
In the Detroit-Livonia-Dearborn area, the Blues have a 55 percent market share, followed by Detroit-based Health Alliance Plan with 26 percent. The Blues have a 69 percent market share in the Warren-Farmington Hills-Troy area, while HAP has a 16 percent share there.
Blues spokeswoman Helen Stojic, however, cited two studies that point to a competitive insurance environment in Michigan.
A September 2009 report from the White House found Michigan's employer-sponsored insurance coverage for families had the lowest premium increases in the nation at 88 percent over a 10-year period.
A May 2010 report by Ken Ross, former Michigan Office of Financial and Insurance Regulation commissioner, found that while the Blues is the dominant carrier in the small employer market, there is a "reasonable degree of competition" in that market statewide and the Blues' size hasn't prevented other insurers from entering the market.
A June report from current OFIR Commissioner R. Kevin Clinton essentially came to the same conclusion.
But the Michigan Association of Health Plans, which represents 17 health plans with 2.1 million members, argues that the size of the Blues needs to be looked at during the review of the Blues' 31-year-old statute by the Snyder administration and Legislature.
Last month, Gov. Rick Snyder called for a "fresh look" at Blue Cross' unique legal and regulatory requirements to encourage competition, lower rates and provide access to high-quality care.
Nationally, the medical association found four of five metro areas have an anti-competitive commercial health insurance market.
"Our new report is intended to help regulators, lawmakers, researchers and policymakers identify markets where mergers among health insurers may cause competitive harm to patients, physicians and employers," Dr. Peter W. Carmel, American Medical Association president, said in a statement.
Tidak ada komentar:
Posting Komentar