“Yes Ms. Gentieu, you really do live in Russia.”

pg24-25After nearly nine months since I made a query with the Ohio Inspector General to look into certain issues at the Ohio Department of Insurance, I received an email response on March 8, posted below. Coming one day after the unveiling of the utterly regressive Republican answer to our healthcare problems, it’s like they are trying to tell me something.  

“Yes Ms. Gentieu, you really do live in Russia.”

But we live in America and we were promised a better, less expensive healthcare plan that wouldn’t leave people dying in the streets.

(Related: Letter to Rep. Latta)

JUNE 29, 2016
Dear Ohio Inspector General:
  1. The Ohio Department of Insurance is granting double-digit rate hikes without any public review, without lowering the hikes. They are basically working for the insurance companies at the expense of millions of Ohioans, including me, whose insurance went up 373% in 7 years, same company.
  2.  The Ohio Department of Insurance is not releasing public documents to me about consumer complaints.
  3. The Ohio Department of Insurance is not releasing rate review justifications for the public to participate in “effective rate review” — with the 5 million dollars in CMS grants meant for this purpose. Other states save their people millions — even a billion — using public rate review, but not Ohio.
  4. The Ohio Department of Insurance has no problem with health insurance companies advertising phony provider networks. There’s no fine or punishment for lying to the public or to the enrollees, so health insurance companies are allowed to rip us off blind!

None of this seems right; or good in the least for the citizens of Ohio, me included. Please investigate.

Ever since I’ve lived in Ohio, my Medical Mutual health insurance rates have gone up double-digits every year. I’ve had the same, or essentially the same health insurance plan with Medical Mutual. I’m a small business person, so I buy individual insurance. The year the plan went on the Marketplace, in 2014, my Medical Mutual premiums went up 224%! The price of my 2016 Medical Mutual insurance is now 373% more than my Medical Mutual insurance was in 2009! In just seven years it went up 373%! The benefits, including the provider networks, of the Medical Mutual insurance in 2009 through 2016 are basically the same.

All of these rate increases were approved by the Ohio Department of Insurance. I found out recently that the state of Ohio received huge multi-million dollar grants from the HHR to assist in the transparency of health insurance rate reviews, and to assist in the containment of rate hikes. The most recent grant was given to Ohio just this month. What does Ohio do with these grants? Other states have saved their citizens at least a billion dollars in rate hikes by using these funds for “effective rate review.” But not in Ohio. The state of Ohio grants rate hikes just as much as the insurance companies ask them for. Double-digit rate hikes, no problem! And Ohio keeps the process secret from their citizens, who they do not engage in “effective rate review.”

I’m not only robbed of my rights, I’m made to be a stooge to the Ohio health insurance industry, an industry that seems to have the Ohio Department of Insurance wrapped around its finger.

I’m just one person getting robbed, in the company of millions of other people getting robbed too – people facing double-digit health insurance rate increases year after year, whether or not health insurance is a part of their employment or they buy it individually. Unsustainable rate increases are happening to everyone in Ohio. Because in Ohio, whatever the insurance companies want, the insurance companies get.

Have you seen lately how we rank as a state? Ohio is the most expensive state for health insurance, see this April 2016 Department of Health and Human Services Brief, Table 4, page 9.

Not surprisingly, not only is the insurance way too expensive, the quality is questionable. A big problem exists with phony provider networks. I made two complaints to the ODI about this issue (see, CareSource complaint here). I wanted to see what other complaints have been made. I requested public records of health insurance complaints, but my efforts were completely thwarted by the Records Custodian at the Ohio Department of Insurance. After six weeks of hassle with them, they gave me a list of 50 complaint numbers and ODI employees the complaints were assigned to, with no other information — not even the the names of the insurance companies that were complained about!

No doubt a problem exists with phony provider networks, because Ohio has no regulation allowing for a punishment or fine for health insurance companies that have phony provider networks. That wouldn’t be something the insurance companies would want, so the Ohio Department of Insurance doesn’t impose such regulation.

Recently, the Ohio Department of Insurance secretly approved the merger of Aetna and Humana, burying the document deep in their website. It didn’t matter to the ODI that the Ohio legislative Insurance committees requested an investigation and public hearing. It didn’t matter to the ODI that consumer groups requested an investigation and public hearing. The ODI went right ahead and gave the insurance companies exactly what
they wanted, without any consideration to what the public and the elected officials asked for — an investigation and public hearing. A simple investigation and public hearing to consider the pros and cons of a merger between two companies representing such a
huge percentage of the market, and how that would affect Ohioans. Hmmmm……

There’s no other way to put it — it’s like we live in Russia.

It is appalling – the lack of transparency in this state!   And that’s not all.

Is it too much to ask from Ohio for the state insurance department to look after the best interests of its citizens when it comes to healthcare, instead of entirely, quite blatantly, enabling the health insurance industry to take utter advantage of us, and strip away any value to what they are selling, as well?

It’s killing us.

I hope you will consider the issues that I have brought up, and help in these ways:

The Ohio Department of Insurance should release public records upon request. Consumer complaints should be searchable on their website, similar to how they are on the Ohio Attorney General’s website, or better yet, like they are on the Texas Department of Insurance’s website. The ODI should do something constructive with the complaints that consumers make, and not just treat them like hot potatoes that they can’t throw far enough fast enough, that they completely erase after only TWO YEARS!

The ODI should create an effective rate review program like many other states have, such as Vermont. The ODI should not grant every rate hike the insurance companies ask for, rather, they should make the process public, and have public hearings about rate increases, in an effort to keep the annual rate hikes down.

It seems obvious, but the Ohio Department of Insurance needs to start serving the needs of Ohioans.

And finally, the ODI should tell me why they allowed Medical Mutual to raise my rate 224% the year it went on the Marketplace and 373% since 2009. (consumer complaint no. CSD-0034217.)

Their response, nearly nine months later:

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2 thoughts on ““Yes Ms. Gentieu, you really do live in Russia.”

  1. Thanks for your imput. Your anger is well placed. I will fight for affordable professional health care for all Ohioans

    1. Thank you Representative Sheehy, I just saw your comment. I appreciate all you can do in Columbus to cut through the censorship of all of Ohioans’ complaints and get our state to help the people who live here instead of doing everything that the insurance industry tells them to do. The next time there is an insurance lobbying event for legislators, I would like to be invited.

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