This op-ed piece originally appeared in The Newport Daily News on June 4,2003

Law must change to return health-coverage choice

By Emily Harding

Have you noticed your health insurance premiums skyrocketing lately? Ever wonder why in other states, your relatives or friends there have more health insurance plans to choose from at much lower rates than you in Rhode Island sometimes at half the cost for better coverage?

Why are your premiums rising so quickly? Why are some of you paying more for health insurance than you do for your mortgage? The answer lies with the Rhode Island General Assembly and its get-tough-on-insurance companies attitude. The companies that used to offer affordable alternatives, such as Mutual of Omaha, the Principal Financial Group, John Alden, Celtic and others, all left Rhode Island for friendlier states last spring.

Lots of myths have been floating around about why Rhode Island only has two insurance companies. One was that the companies didnt find Rhode Island profitable enough. Wrong. If that were so, then why were they doing business in Rhode Island for decades? One myth was that they couldnt compete with Blue Cross. Wrong. Again, if that were true then why did they stay in Rhode Island for so long? Another myth is that Rhode Island is just too small a state. Wrong again! If Rhode Island was too small, why did they come here and do business here for decades? The truth is simply that the legislative environment got too restrictive for carriers to do business in Rhode Island anymore.

So now that we in Rhode Island have gotten so tough on insurance companies, is everyone happy? Do you feel more protected now? If not, are you motivated enough to let your state senator and representatives know about it, or are you going to let things get even worse?

Independent agents and health insurance brokers who are members of the Rhode Island chapter of the National Association of Health Underwriters, as well as government affairs experts from the associations headquarters, have been working all year with the Rhode Island legislature. Although some progress has been made, there seems to be an unwillingness by the General Assembly to address the particular rules and regulations that drove the carriers out in the first place. These Rules and Regulations for Certification of Health Plans, R23-17.13-CHP, essentially force all health plans to be responsible for the quality of care the doctor whom you see provides. The rules also say that the insurance company has to be responsible for the doctors malpractice.

The good news is if these rules and regulations are addressed, the carriers will return to Rhode Island and bring with them affordable health insurance options, which will help to stabilize the overall market. The bad news is Rhode Island legislators, without a big push from their constituents, arent motivated to do what is necessary to get these carriers back. The Rhode Island health underwriters have developed a brief seven-question online survey on the NAHU Web site that is designed just for Rhode Island residents and business owners to provide feedback to legislators. The results of the survey are sent directly to your state legislators.

What Rhode Island legislators cant seem to understand is that there are two kinds of health insurance plans those that have control over doctors quality of care and malpractice, like HMOs, and those that dont, like all the plans offered by the carriers that left Rhode Island last year. These companies all had plans that let you go to any doctor and any hospital anywhere. They had options to let you use a preferred provider organization, or PPO , if you wanted, for a discount. These plans let you control your care. They never controlled it like HMOs do, and since they dont control it, they also dont control which doctor you see or the quality of care that doctor might or might not provide. With these kinds of plans, if you didnt like the care provided by one doctor, you were free to go to another, as opposed to plans such as HMOs that require you go through a primary-care physician who decides what care you can and cant have.

Essentially, these laws force non-HMO plans to act like HMOs. However, just as you cant make an apple be an orange, you cant make a PPO plan or an indemnity plan be an HMO.

The even worse news is health-care costs and options arent going to get any better for Rhode Island residents and businesses until Rhode Islanders speak up about it to their legislators in the Statehouse. What will stabilize the market and bring affordable options back to Rhode Island is competition from other insurance companies. Rhode Islanders need to demand that legislators do whatever is necessary to get carriers to come back to Rhode Island if they want to see any improvement. The NAHU-sponsored survey is designed for Rhode Islanders to do just that.

New Hampshire went through a similar crisis a few years ago, of which Rhode Island legislators are well aware. The difference between New Hampshire and Rhode Island is that New Hampshire realized what laws the carriers that left their state had a problems with and changed them. Now New Hampshire has carriers returning and more affordable health insurance options every day for its residents. Rhode Island, on the other hand, hasnt done enough to make anything better for Rhode Islanders.

So if you are happy with the way things are in Rhode Island, do nothing. If youd like more health insurance options and lower health-care costs, now is your time to act by participating in the online Rhode Island Healthcare Satisfaction Survey at the National Association of Health Underwriters Web site,, and let your state senators and representatives know how you feel.

A few minutes of your time could end up saving you thousands of dollars in health insurance savings. The sooner carriers return to Rhode Island, the sooner everyone can begin save again on health care.