President of Anthem Addresses Bedford Republicans

Tonight Lisa Guertin, President of Anthem, the only health insurer participating in the New Hampshire ACA Exchange, spoke in front of a group of civic-minded Bedford citizens, at an event organized by the Bedford Republican Committee.

Ms. Guertin hails from Connecticut, and has been involved in the health insurance industry in New Hampshire since the early 1990's.  Ms. Guertin's comments tonight were non-partisan and apolitical, and addressed the challenges her company has faced and the road ahead, in a straightforward, sincere and transparent talk.

Ms. Guertin remarked about how four years ago when Obamacare was signed into law, Anthem was faced with the decision of whether to engage in the exchanges or not.  They believed there would be other insurers also joining in the exchanges.  They were wrong.  Only Anthem stepped up.  And it has been a difficult road.  All of the changes on the fly and delays have caused upheavals in their operations.

Ms. Guertin spent a lot of time discussing why they were forced to narrow the hospital network.  Anthem found the most important aspect of insurance for people is affordability.  Given the new ACA rules, such as pre-existing conditions must be covered in the regular pool (as opposed to high-risk pool), Anthem was forced to move to a narrow network on the individual market.  If Anthem kept all hospitals in that network, the cost of an individual health plan would have increased substantially.  The way Anthem went about keeping the individual premiums down was by reducing the number of hospitals available in the individual network, and in exchange negotiating better rates with the hospitals in the narrow network...because theoretically those hospitals would see an uptick in volume given the reduced competition.

Despite the narrower hospital network the network of doctors has remained comprehensive.

The topic of the current Exchange enrollments was discussed.  Currently around 17,000 members have signed up and paid.  By the end of March that count is expected to be around 20,000.  As of now the number and demographics are about on par with what was projected.

Ms. Guertin discussed that there are a lot of politicians talking about "fixing" problems in the health insurance arena, but cautions about some supposed remedies possibly making things worse.  There is the concern about unintended consequences.

Asked about the factors that cause insurance rates to go up, and specifically about medical malpractice lawsuits, Ms. Guertin agreed that defensive medicine and lawsuits do have an impact.  Tort-reform is something that Anthem advocates on occasion.

It is expected that next year there will be a couple of new insurance companies to the exchanges.

In summary, when given the choice of whether to walk away from their customers or try to make it work, they chose to try to make it work.