Lawmakers expand investigation into health insurance rate hikes

The scope of a congressional investigation into health insurance rate hikes in California expanded Tuesday as lawmakers summoned the chief executives of four of the nation’s largest for-profit health insurers to testify about medical claims denied for individuals with preexisting conditions.

The House Committee on Energy and Commerce and its investigations subcommittee are targeting the practices of WellPoint Inc., UnitedHealth Group, Humana Inc. and Aetna.

The companies provide insurance to a large share of the estimated 17 million Americans who buy individual insurance policies because they do not have health coverage through jobs.


The Subcommittee on Oversight and Investigations already is examining rate hikes of as much as 39% planned by WellPoint’s California subsidiary, Anthem Blue Cross.

WellPoint agreed to postpone the increases, which have caused a national uproar, until May 1 while California’s insurance commissioner determines whether they can go forward.

WellPoint CEO Angela F. Braly testified before the investigations subcommittee last week, telling lawmakers that the premiums are a reasonable response to rising medical costs. A WellPoint spokeswoman said Tuesday that the Indianapolis-based company was reviewing the lawmakers’ latest request in letters to the four insurers.

“We will respond appropriately,” WellPoint’s Kristin Binns said.

A Humana spokesman said the company also was reviewing its letter. An Aetna spokeswoman said it intended to cooperate. UnitedHealth could not be reached for comment.

The industry’s Washington-based lobbying arm, America’s Health Insurance Plans, defended its members’ track records. It cited its own 2007 survey that said health plans denied just 2.36% of claims in 2006. Another 2009 survey by the group found that 87% of insurance applicants undergoing medical review were offered coverage.

Still, in the expanded congressional inquiry, full committee Chairman Henry Waxman (D-Beverly Hills) and subcommittee Chairman Bart Stupak (D-Mich.) have called the heads of the four insurance companies to testify March 23 about denying claims for policyholders with preexisting conditions and refusing coverage for potential customers with medical conditions.

Specifically, the lawmakers are asking the companies to provide internal e-mails and documents related to underwriting policies, guidelines and practices for the last five years.

They also want the insurers to list their average premiums and average increases. And they want information about the companies’ maternity care coverage in the individual market. Waxman and Stupak asked the insurers to provide the information by March 12.

Other members of Congress and the Obama administration also are asking large insurance companies to justify rate increases.

Health and Human Services Secretary Kathleen Sebelius is scheduled to meet Thursday with several insurers to discuss rate increases; the meeting at the White House was postponed a day because of scheduling conflicts.