Testimony Before Legislative Committees

Testimony in Support of Rate Review
March 3, 2015
Testimony in support of SB 89

To the Senate Small Business, Insurance and Industry Committee.

Women’s Voices Raised for Social Justice, an advocacy and education organization reaching more than 700 women in Missouri, supports a simple and transparent rate review process. Consumers need to  know why their health insurance premiums increase in price.  Consumers should be protected from excessive, unfair or discriminatory rate increases. Insurance companies should be required to provide information to the Department of Insurance justifying their rate increases and the Department of Insurance should have the authority to approve or disapprove these increases.   Consumers need protections

According to the Department of Insurance website, Missouri is the only state in the country that does not require health insurance companies to file and justify their rates. Missourians would greatly benefit from the Department of Insurance having rate review and prior approval authority.

Women’s Voices supports SB 89.  We urge the committee to move this bill forward


Mary Clemons, past president and chair of the Women’s Voice Health Care Advocacy Committee

Testimony in Support of Rate Review

March 3, 2015

To Members of the Missouri Senate Small Business, Insurance and Industry Committee:

My name is Bernadette Gronborg, and I am a resident of Festus, Missouri. I have been married 47 years, and my husband and I are blessed with four grown sons and seven healthy grandchildren. I am also a Board member of the statewide organization, Missouri Health Care for All.

I’m grateful to Senator LeVota for the bill he has brought forward, SB89, that would require health insurance companies to file their premium rates with the Department of Insurance for approval.

In our state, and truly in my own family, there are people who look upon the yearly increases of their health insurance premiums with dismay, and wonder why it is happening. Sadly, they have no answers at all and no recourse because we are the only state in the nation without oversight of health insurance rate increases.

How do we know that citizens in the state of Missouri are being charged fair and reasonable rates for their health insurance policies? We simply have no transparency whatsoever for consumers in this state, and no way of knowing if, in fact, consumers are being treated fairly.

Don’t Missourians deserve the same protections afforded to citizens in every other state of this great country? Don’t our citizens deserve transparency? Don’t our citizens deserve the probable lower insurance premiums that would result from this oversight?

I strongly support SB89. Please agree, and give the State of Missouri authority to protect consumers who purchase health insurance.

Bernadette Gronborg

Testimony March 2013 in opposition to eliminating Insurance Subsidies
March 3, 2015

To The Missouri Senate Small Business, Insurance and Industry Committee

Testimony in Opposition to SB 51

Women’s Voices Raised for Social Justice urges you to oppose SB51.

Currently, more than 217,000 moderate-income Missourians are receiving subsidies, or discounts, on health insurance purchased through the Health Insurance Marketplace. For most of these people, the insurance would be unaffordable without the discounts they receive. In fact, a study by the Rand Corporation estimates that 70% of these people would lose their health insurance if they were to lose their discounts. In other words, SB 51 could lead to nearly 152,000 Missourians losing their insurance.

In addition to the direct impact on people currently receiving discounts, this bill would affect the entire insurance market. Without the discounts that make insurance affordable, many healthy people would choose not to pay for insurance, leaving an insurance pool that is sicker and more expensive to insure. As a result, insurance premiums would likely rise for everyone – as much as 47%, according to the RAND Corporation.

We believe SB 51 is bad policy and asks that you oppose this bill.

Mary Clemons, past president and Chair of the Women’s Voices Health Advocacy Committee

President Provides Testimony For Medicaid Expansion
February 22, 2013

Testimony in support of HB627
Submitted to Missouri House of Representatives Government Oversight and Accountability Committee

My name is Mary Clemons. I am the president of Women’s Voices Raised for Social Justice. Women’s Voices, an organization of 560 women, supports the expansion of Medicaid (Missouri Health Net) and urges you to vote in support of this important bill. Currently Missouri has such strict eligibility restrictions that a single mother earning more than $3,500 a year is not allowed to enroll in the Health Net program. And single adults without children don’t qualify at all. Our disabled neighbors who earn more than $792 a month aren’t eligible for coverage. Choosing between caring for your family or buying needed medication isn’t the kind of choice our citizens should have to make. As I heard someone say recently, our safety net has holes. We have an unprecedented opportunity to patch the net and give over 250,000 uninsured Missourians needed health coverage.

I would hope that this bill would have bi-partisan support. The diversity of groups supporting Medicaid expansion – from the Missouri Chamber of Commerce, the Missouri Hospital Association, the Missouri Association of Social Welfare, and the many organizations in the Missouri Medicaid Coalition – makes it clear that this is an issue that resonates across political party lines and in communities across the state – urban and rural. Studies have shown that expanding the Medicaid program would provide needed jobs in the state. And the studies have shown that our hospitals, particularly in the rural districts, would be at risk without the expansion. And as governors across the country who had not supported the new health care law are now realizing, Medicaid expansion makes good sense. As Gov. Rick Scott said this week, “While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care.”

Women’s Voices for Social Justice commends Representatives Hummel and Kirkton and the sponsors of HB627 and urges the Committee to move this bill forward for the benefit of the citizens of Missouri.

Members Testify At Hearing on Insurance Rate Review – Feb. 2012

Women’s Voices member Sue Bohm presented testimony at the hearing of the Missouri House of Representatives Health Insurance Committee. She told her personal story of exorbitant health insurance premiums and showed the increases over a four-year period.

Member Sidney Watson, professor of Health Law at St. Louis University, presented testimony as an expert witness.

Testimony in support of health insurance rate review
HB 1546 and HB 1711
Submitted to the Missouri House of Representatives
Health Insurance Committee

My name is Sue Bohm, and I live in Chesterfield MO. I am here today to give you a perspective from a consumer of individual health insurance. My family and I have been in this lonely place for about a decade. We had a very successful retail business for many years, and we closed it when it became evident that we were going to start losing money if we tried to compete with the big chains. We couldn’t meet their prices. We provided health insurance to our employees; even back then it was getting more expensive. When we left, we were in the “no man’s land” of health insurance. We were turned down by every company we applied to, and we wound up getting insurance from the state. It had the worst coverage, and it was the most expensive. Before we moved on, we were spending $24,000 a year, more than what it cost to insure all our employees when we had our business.

We have spent the past five years as “customers” of GHP. I say that loosely because we are currently at their mercy. During these years, some of us have had issues that all insurance companies call “pre-existing conditions.” Therefore, no other health insurance provider will take that person. We have had to endure yearly premium increases from 6 to 24%. Below is a list of monthly payments that we have made for the past four years. I have listed each person individually to show each percent of increase and because we each have individual policies. Also, this dollar amount doesn’t include deductibles, co-pays, and all prescription payments (these are not even entered into the out of pocket expenses limited by the company). My husband and my policies have gone up every year probably because of our age (neither of us has incurred a lot of medical expenses other than yearly tests). My husband’s policy this year was going to increase 15%, after 3 years of almost double digit increases, but we had to cry “uncle” and go to a $2000 deductible — double what it was. My new rate is due to be presented in March. I dread seeing what I will have since I am a year older than my husband.

Could you possibly hurry this along so I can be your first rate review? In a perfect world, we would be here discussing the formation of a state insurance exchange. That really is the only thing that would truly help my family and the many others who are forced to pay exorbitant premiums for individual insurance, but I’ll take what I can get.

I strongly support this rate review legislation. Insurance companies should provide a public process for rate reviews and the state should have the authority to deny excessive rates. Someone should stop them. If not you, then who?

Sue Bohm

Testimony at Senate Hearing on Resolution 27 – January 2011 in opposition to repealing health care act

With very little notice, Women’s Voices members Amy Smoucha (St. Louis Jobs With Justice health care organizer) and Stacey Sickler (Missouri Health Care for All), recruited 60 people from across the state to attend a Senate hearing in Jefferson City to oppose Senate Resolution 27 calling on Attorney General Koster to sue the federal government to repeal the Patient Protection Affordable Care Act. Seven members of Women’s Voices responded.

Twenty members of our coalition testified at the hearing concerning the benefits of the Affordable Care Act as compared with the current situation. Some of the stories:
• Under the new law, no lifetime maximums. A grandmother told about her granddaughter fighting cancer and approaching – at the age of 4 – her life time maximum.
• Under the new law, children under 26 can be insured on their parent’s policies. A young woman told of dropping out of college when she was diagnosed with cancer in the palate of her mouth. Because she was no longer a full time student she was dropped from her parent’s policy.
• Under the new law you can’t be denied insurance for pre-existing conditions. An active, healthy woman blind since the age of 8 who ran a successful business could not buy insurance at any cost.
• Under the new law we will be able to buy individual policies under an exchange. A man in his 30s testified about being laid off, becoming uninsured, and staying home to care for his child. He contracted shingles, went untreated and now suffers from serious complications.
Four members of Women’s Voices testified during the hearing.

• Bunnie Gronborg told about the benefits of the new law allowing purchase of insurance with pre-existing conditions. With easily controlled hypertension and a sister who is a breast cancer survivor, she could only purchase a policy with a $15,000 deductible that excludes many conditions.
• Barbara Richter told how under the new law the rates for women will be no higher than for men. Small businesses, which frequently employ more women than men, will be able to receive subsidies for insuring their employees and have lower premiums than they currently have.
• Rea Kleeman testified that the new law will make it possible for families currently with no insurance to be covered.
• Mary Clemons related how the new law would reduce Medicare and Medicaid fraud, and provide transparency regarding ownership of nursing homes and conflicts of interest between doctors, medical equipment and drug companies.

Following the hearing Attorney General Koster graciously met with us, and we urged him to reject any call to join in a law suit opposing the Affordable Care Act. We presented him copies of our written testimonies.
Testimony Statements of Bunnie Gronborg, Barb Richter, Mary Clemons and Jeanne Bubb

Members Testify At Senate Hearing on Implementation of Health Insurance Exchange – Nov 2011

Nine members of Women’s Voices turned out to support the planning, funding and implementation of a health insurance exchange in Missouri when the state Senate Interim Committee on Health Insurance Exchanges met in St. Charles on Nov. 10.

Sue Bohm told of paying $18,000 a year for individual insurance policies for her family of four, and stated that she has just learned the premium next year will reach $21,000. Barbara Richter told of her problems in negotiating for insurance for employees when she and her husband had a small business. An exchange would have helped her find the best policy without having to go from company to company and agent to agent before purchasing a plan that she didn’t understand and that ultimately did not provide the services her employees needed. Mary Clemons spoke on behalf of all of the women in Women’s Voices. Read their remarks here.

Sidney Watson, Women’s Voices member and professor of law, Center for Health Law Studies, St. Louis University, told the committee why Missouri should set up its own exchange rather than allow the federal government to create one under the Affordable Care Act. Members Amy Smoucha and Stacey Sickler were responsible for the large number of attendees at this hearing. There was standing room only, and it was estimated that 75 percent of those in attendance were supportive of the ACA and Missouri implementing health insurance exchanges. Members Joyce Clark, Bunnie Gronborg and Jeanne Bubb also attended the hearing. Of the 37 people who testified, only seven were opposed to creating a health exchange in Missouri.

The testimonies –

Mary Clemons, President, Women’s Voices Raised for Social Justice

I am the president of an organization of 550 women. Some of us are single; some are widows; some are married; many of us are on Medicare; most have children; and a lot of us have grandchildren. But what we all have in common is disgust — disgust with the legislature in Missouri that seems hell bent on obstructing the law of the land. It is inexcusable that a process is not already underway to develop health insurance exchanges.

Some of our members have insurance deductibles that are so high they put off going to the doctor. One didn’t go to the doctor until her blood pressure reached 170 because she would have to pay the cost of the doctor visit. One of our members had a small business (one of those job creators you are so fond of). She could only afford a high deductible policy, put off going to the doctor and then found she had stage 4 breast cancer. And then her high deductible carrier even refused to pay for treatment her doctors ordered. She died before she reached the age of 40. Some of us have insurance premiums that are so high they question whether to keep the policies. Some have children who haven’t had raises in 4 years or who have lost jobs and to pay bills cancel their health insurance. Some have grandchildren who have health conditions that will prevent them from getting insurance when they will need to purchase it on their own.

These problems could be resolved with a true health insurance marketplace that would allow individuals and small businesses to compare and choose policies that fit their needs. But while Missourians suffer you have token hearings and don’t really listen to those of us who come before you. When we do speak, you don’t really hear us. You may give a condescending pat on the back – as you did to one of us who testified at a hearing last year – but we don’t want pats on the back when we tell our tales of insurance woe; we want action. We’re tired of your refusal to provide us the services called for in the Affordable Care Act.

Do you not understand that our economy would be improved if our member who is currently paying $18,000 a year for health insurance for her family of four could spend some of that money making purchases at our businesses? Do you like going from one store to the next to the next trying to find the best price for a major family purchase only to discover you can’t really compare the prices because each store has different models? I don’t understand why you wouldn’t jump at the chance to create a competitive market place where individuals and small businesses could make one of the most important purchases affecting the lives of our Missouri families – where they could find insurance they can afford and be confident that the policy includes the quality coverage they need.

It seems to many of the members of my organization that those of you opposing the Affordable Care Act are doing so purely for political reasons. While you remain loyal to your heartless ideology you brush aside the fact that many of us are already benefitting from the provisions in place and that many more of us would benefit from the creation of an insurance exchange.

My name is Mary Clemons. I am the president of Women’s Voices Raised for Social Justice. We have been raising our voices. But we have yet to receive justice.

Bernadette Gronborg, Festus, Missouri

Honorable Senators, my name is Bernadette Gronborg and I am a resident of Festus, Missouri.

I proudly serve on the Board of Missouri Health Care for All, a grassroots, non-partisan movement of faith and community leaders committed to securing quality, affordable health care for all Missourians. We have more than 7,000 grassroots members and over 130 endorsing organizations in the State who have endorsed our Principles for a just health care system. Missouri Health Care for All strongly supports the establishment of a competitive health insurance marketplace, an insurance exchange, in Missouri.

In addition, I am an INDIVIDUAL who must purchase health insurance for myself and I feel that my experience points out the need for an insurance exchange in Missouri. As an individual consumer of health insurance, I have experienced multiple rejections by insurance companies. Faced with the very few choices for health insurance in Missouri, I have found myself stranded with a high deductible ($15,000) exclusionary, nearly worthless policy for which I pay steadily increasing premiums of over $300 a month.

Like most individuals who have such pseudo coverage, I rarely choose to see my physician because virtually everything is an out-of-pocket expense. In just the last two weeks, I experienced dangerous blood pressure spikes and found myself in the good doctor’s office for an appointment that should have happened much sooner. I’ve tried to do the right thing by insuring myself, but what good is this “insurance” doing me? I would give anything for an ability to SHOP for real choices in a market based insurance exchange similar to the one currently enjoyed by the citizens in the state of Massachusetts, The Massachusetts Connector.

The only thing stopping Missouri from establishing such an exchange is the political obstructionism of a handful of Missouri Senators who are using the Affordable Care Act (ObamacareS) as a tool to beat down the real needs of citizens and small businesses in the State. In my opinion, even if the proposed insurance exchange had nothing to do with the implementation of the ACA, it will STILL BE a vehicle for competition, affordability, transparency, guaranteed coverage and accountability for citizens and small businesses who need to purchase insurance in our State. If these same Senators are allowed to stand in the way of real choices and affordability for the citizens and businesses in our state, they will NOT ever attempt to come up with another solution for us. They may suggest “buying across state lines” as a solution, but that offers zero protection for the citizens of this State from “fly by night” operations of questionable origin.

In an attempt to block insurance exchanges, some have made a false argument that “71 percent of Missouri voters” passed Missouri Proposition C in 2010, and therefore Missourians don’t want any part of the Affordable Care Act…even exchanges that would benefit them. Election results posted on the Missouri Secretary of State’s site the day after that election showed that only 22.9 percent (938,782 out of 4,104,834) of registered voters actually voted in the 2010 election in our state. Only 16 percent (666,535 out of 4,104,834) of registered voters passed Prop C. Again: ONLY 16 PERCENT passed Prop C. The total “yes votes were about 71 percent OF THOSE WHO ACTUALLY VOTED. 16% of registered voters in the state is not a mandate for anything.

I am respectfully pleading, in the name of all Missourians who must purchase health insurance coverage, that we be given the opportunity to actually shop for our coverage in an insurance exchange similar to the Connector in Massachusetts. Please don’t allow bad politics to drive out a good policy for Missouri.

And may I suggest a name for our exchange? — Show Me Missouri Health Insurance

Barbara Richter – Kirkwood, Missouri

My name is Barbara Richter and my husband and I were small business owners of a manufacturing company that manufactured indoor day care equipment. We had our offices in Kirkwood, Missouri and our manufacturing plant in Union, Missouri. We sold the business in 2006 and it is still at the same locations and continuing on. One of my biggest headaches as a business owner was dealing with health insurance for our employees. When we were first in business, we were too small to qualify without doing health statements on each of our employees. My husband has heart disease and our Plant Manager has diabetes and heart disease so we could only qualify for extremely expensive insurance which we could not afford. Once we had 25 employees, we could get insurance without the health statements so we were able to obtain group coverage at that time. Every year we dealt with increasing costs to our premiums and constant changes to our insurance plan to try to keep cost under control. One year we purchased insurance that did not include durable medical equipment. I asked what that was and the broker said crutches, canes, etcs. I thought that would be okay until my employees started complaining that their test strips for diabetes and their syringes were not covered under our plan. I was horrified to discover this because my employees said some of them were just not going to manage their diabetes because it was too expensive for them. I decided to reimburse them the full cost of these items because I knew the serious damage that would occur to their health if they let their diabetes get out of control. This is just one example of the multiple, complex issues we deal with in securing adequate health coverage for our employees. I have a masters degree and I cannot understand or compare the differences between plans because they are all so different, complicated, and use different language. We need health insurance exchanges to make the variables more understandable so ordinary people can make good decisions about their coverage.

Another issue we faced every year was the unpredictable and unexplainable premium increases we were given. One year we received a 49% rate increase that didn’t make sense to us and caused us to switch plans again and again to keep the costs down. This was very disruptive to our employees to be switching plans and coverage constantly. We didn’t want to make these switches, but we had no other choice. We need rate review so the rate increases are studied by an outside body to shine a light on these outlandish rate increases. No other industry that we deal with in our business handles rate increases this way and we have very few alternatives to compete with the available health insurance plans in our area.

We were a successful manufacturing business and we were purchasing health insurance for about 100 employees however, there were many years that our pool was smaller as we grew over time. It is still going strong today, employing fewer people due to the economy but still strong. Health insurance coverage for our employees was a constant, nagging issue that took us away from our real business, which was manufacturing play equipment for children. Missouri needs health insurance exchanges and rate review to make our insurance system run more efficiently and effectively.

Sue Bohm – Chesterfield, Missouri

My name is Sue Bohm and I live in Chesterfield, Missouri. My husband is currently self-employed, and we have 2 sons, ages 18 and 16. We used to own a small business and we had the minimum number of employees to enroll in a group plan. When we closed the business (after a very good run) we looked for individual coverage, and our entire family was turned down for insurance from every reputable company due to pre-existing conditions. We had to sign up for Missouri’s HPPA insurance which was incredibly expensive, and we were in a pool with the sickest people in the state. The four of us had several pre-existing conditions but have been generally healthy for the most part. We finally found a company that would accept us each as an individual plan but the premiums have risen every year to the point that we spend over $18,000 a year for a husband and wife over 50 and two boys,18 and 16. I look forward to the day where we can shop around and not pay this much. Think of the disposable income we would have if it weren’t spent on health care. This is like buying a new car every year. A state exchange would generate revenue from people like us who might have more money to spend instead of giving it to GHP. We are especially interested in the exchange providing coverage for people with pre-existing conditions and keeping premium costs reasonable.

Thank you for holding this hearing and for providing me an opportunity to tell you of my support for the State of Missouri establishing a strong Health Insurance Exchange.