BC Raises Costs Of Individual Health Plans in Michigan
Story from the Detroit News

As more Michigan residents flock to Blue Cross Blue Shield of Michigan to buy their own health coverage, the state's largest insurer is replacing several types of individual policies with plans that will cost up to $600 a year more -- and come with higher co-payments and other out-of-pocket costs.

The new insurance plans -- with monthly premiums ranging from $51 to $292 per a person -- are on sale now and take effect Wednesday.

On March 27, Blue Cross stopped enrolling new consumers in several older plans, including Value Blue, a catastrophic coverage policy, and its no-deductible Individual Care Blue. The changes don't affect Blue Cross members enrolled in those plans. Instead, the new rates will apply to newly unemployed residents seeking to replace workplace coverage by buying their own insurance from Blue Cross. The new plans also differ from those for which Blue Cross is seeking state permission to raise rates and would not be affected if that request is approved.

With the rollout of these new plans, Blue Cross has introduced a lengthy application that includes optional health questions and ties insurance agents' commissions to the medical condition of new enrollees.

The changes are so drastic that some insurance agents say Blue Cross is deliberately making its money-losing individual policies less attractive to slow sales. Blue Cross contends that it's simply keeping up with market trends, as well as the rates and plan offerings of its private-sector competitors.

As the state's insurer of last resort -- a responsibility tied to its tax-exempt status -- Blue Cross must cover all Michigan residents, regardless of their medical history. But that arrangement, Blue Cross officials say, leaves them with the state's sickest and costliest members. Last year, Blue Cross lost $133.2 million on individual insurance policies, dragging its bottom line to a $144.9 million loss for 2008.

Insurance agents say the new rates will make it harder to sell the plans. New members aren't going to want to pay more in premiums for higher out-of-pocket costs, especially if there are better deals offered by other insurers.

"It's not good for the consumer," said Patrick Pennefather, president of the Michigan Association of Health Underwriters, which represents health insurance agents and buyers for employer groups. The new plans, he added, are going to slow down sales for Blue Cross, a move that could help stem the rising tide of losses on individual policies.

Some agents are likely to stop selling Blue Cross' individual policies altogether because the commission structure lowers incentives for enrolling sickly customers into its individual plans, Pennefather added.

Blue Cross's new incentive structure offers a 15 percent commission to agents who sign up healthy members and only 2 percent for signing new enrollees with severe medical problems. A 2 percent commission could translate into only a couple of dollars a month on some policies, say insurance agents, and is much lower than the 8 percent commissions previously offered by Blue Cross on all policies, regardless of the applicant's health status.

Blue Cross said the tiered commissions better match incentives offered by their rivals in the individual insurance market.

"It may drive a lot of agents out of the individual insurance business. In fact, many have said they plan to get out of it," Pennefather said, noting that agents can make 20 percent with other private insurers.

Some Blue Cross critics, including Michigan Attorney General Mike Cox, have questioned why Blue Cross is collecting health information, since that is at odds with the company's mission as the state's insurer of last resort. Cox's office has said it's investigating whether the changes are lawful.

Answering the questions about health status, however, is voluntary and won't affect consumer eligibility or rates, but will help applicants qualify for lower co-payments, Blue Cross officials said.

Blue Cross also points out that it still pays at least some portion of the commission to agents for all applicants. Most other insurers pay no commission if they end up rejecting the applicant, said Helen Stojic, a Blue Cross spokeswoman.

As for the new plan prices and coverage, Stojic said Blue Cross hopes to better reflect the marketplace, where deductibles and higher out-of-pocket maximums are common.

The insurer also contends its rates are still better than most plans for people with serious medical conditions.

"Our plans are aligned more closely with those in the market, with one important difference: We still don't medically underwrite and we are still the insurer of last resort," Stojic said.

Unlike rate hikes for existing customers, state regulators don't require Blue Cross to seek public input before introducing new plans or closing new enrollment in existing policies.

Blue Cross is seeking rate hikes on its existing individual policies that cover about 400,000 members. It's asking for an average rate hike on three types of policies: a 56 percent increase on individual plans, 42 percent on group conversion coverage (which extends benefits from a former employer) and 31 percent for Medigap plans.

Subsidies For Private Medicare Plans
On The Chopping Block
Story from the Wall Street Journal

The government late Monday is expected to set in stone the 2010 rates it will pay health insurers to run private Medicare plans. Most signs suggest that cuts are coming in the subsidies that the industry got during the Bush administration.

Stocks of health insurers were sucked into a surprise tailspin in February after Medicare officials signaled they planned an effective 5% cut in those payments after formula adjustments. Insurers, medical societies and others have had six weeks to give regulators their arguments before the payment rates become final for next year.

Their arguments, plus an effort by 17 senators from both parties who on Friday urged Medicare to reconsider the way it calculated the effective cuts, could sway the Centers for Medicare and Medicaid Services to compromise on the new payment rates, as the federal agency has in previous years. But its new management hasn't given any hint of letting up on efforts to rein in federal subsidies for the private-sector Medicare plans.

More than 10 million beneficiaries get their medical and drug coverage through so-called Medicare Advantage plans, which the Bush administration promoted with extra benefits for seniors and by providing subsidies to insurers that offer them. President Barack Obama wants to finance a good chunk of his health-care agenda by cutting those payments over time to the level of traditional Medicare's per-patient outlays. But the rates signaled in February by the new administration caught insurers -- and Wall Street -- off guard by cutting payments so soon.

The stock performance of big Medicare Advantage players on Friday suggested that many investors "don't believe it will be a positive surprise," said Matthew Borsch, analyst at Goldman Sachs. Humana Inc., already down 30% for the year, shed $1.54, or 5.7%, to $25.46 on Friday.

If the payment cuts remain or change little from those proposed, insurers may raise premiums or cost-sharing amounts, such as copayments The Blue Cross Blue Shield Association argues that the cuts could translate into premium increases or benefit reductions of between $50 and $80 a month for seniors. That could slow enrollment in a business that has been critical to many health insurers' profit growth in recent years.

Medicare Advantage wraps physician and hospital services in one. Unlike traditional Medicare, the government doesn't pay providers directly but instead pays insurance plans to manage care.

The Obama administration argues it wants to make sure the plans aren't overpaid while not providing value or better care. Last week, it took steps to tighten screws on the private plans on another front, setting new caps on what insurers can charge sick seniors and ordering them to be more upfront about what they cover.

BCBS of Michigan to Cut Up to 1000 Jobs
AP Story Posted to MLive.com

LANSING -- Blue Cross Blue Shield of Michigan said Friday it plans to eliminate up to 1,000 jobs and make other budget cuts this year in another blow to the state's economy.

The nonprofit health insurance giant said the moves are necessary to preserve its financial health. Blue Cross had hinted at possible layoffs last year after the Michigan Legislature did not pass changes to insurance rules sought by the company.

The job eliminations could affect more than 10 percent of the Blue Cross system's roughly 9,000 Michigan employees, including its subsidiaries.

Blue Cross Blue Shield employs 250 in its downtown Grand Rapids office.

Blue Cross has said it wants law changes because it is losing millions of dollars each year on health insurance policies that cover individuals.

Blue Cross customers also could feel the brunt of the company's actions. Blue Cross plans to request average rate increases of 55 percent for individual plans, 42 percent for group conversion plans and 32 percent for Medicare supplemental plans.

"We should not ask our individual subscribers to pay more without first demanding sacrifices from ourselves," Blue Cross Blue Shield of Michigan President and CEO Daniel Loepp said in a statement. "Our goal is to move forward as a strong and financially stable nonprofit company, committed to fulfilling our mission and delivering the best value in health insurance products and services to our customers."

Loepp said the company faces losses of $1 billion through 2011.

Blue Cross plans to trim 400 jobs from its core business and its Blue Care Network HMO subsidiary within the next 60 days. The other job cuts would come later in the year.

Some senior executives will face a salary reduction, the company said, while other executive pay will be frozen. Salaries of non-union employees will be frozen, and the United Auto Workers will be asked to delay a 3 percent pay increase planned for the Blue Cross employees it represents.

The company plans to reduce advertising and lobbying by 25 percent. Discretionary spending such as travel also will be cut by 25 percent.

Blue Cross is a nonprofit organization playing a unique role in the state's health care system. It can't deny any customer health insurance as long as the customer pays for it, making it the state's insurer of last resort.

In exchange for a mission of improving access to health care coverage, the nonprofit company is exempt from many state taxes.

The company's annual revenues were about $19 billion in 2007.

Editorial: Blue Cross reform should wait until '09

by The Flint Journal

Sunday December 07, 2008, 6:00 AM

All good things in time. If you believe that adage, then you have to believe good legislation on the issue of individual health insurance will require more time than the Legislature has between now and the end of the year.

Blue Cross Blue Shield of Michigan has been pushing hard for lawmakers to approve changes in the way the state regulates health insurance that people have to buy individually because they don't have coverage through an employer.

That attempt is meeting opposition, particularly from state Attorney General Mike Cox, who says the proposed changes would hurt consumers and give Blue Cross an unfair advantage over its competitors.

The battle between Cox and the Blues has gotten a little nasty. That's unfortunate, because this highly complex issue can be resolved only with measured debate, not with the snide attacks that both sides have launched at times.

That aside, Cox is arguing that the lame-duck session doesn't allow enough time or the right climate of deliberation to deal responsibly with the issue. On that much he is right.

The state House erred when it passed a reform package that some lawmakers later admitted didn't get the consideration it needed. The Senate approved a more-thoughtful package, but differences between the two haven't been reconciled.

Blue Cross now wants action. We understand the insurer's desire for reform. It recently announced that in the first nine months of 2008, it lost $111 million on individual policies.

As the number of people seeking them grows, those losses will only mount.
The attorney general argues that Blue Cross remains financially sound, but the insurer faces long-term losses that would jeopardize its financial health in ways Cox isn't acknowledging.

Under state regulations, Blue Cross receives special tax benefits and in turn has a special responsibility to the public. It deserves reasonable reforms, but the attorney general's oversight should be preserved in a meaningful way.

In November, a compromise proposal became public, but we don't see how lawmakers can responsibly review such a complex plan in a short lame-duck session, nor do we think the issue should be decided by 46 House members who are leaving office and don't have to answer to voters for something rushed too quickly through the legislative process.

This issue is too complex, and there's too much at stake.

BCBS of Michigan Could use a little Bailing Out

Michigan’s Largest Health Insurer Sings Financial Blues

Posted by Victoria E. Knight

Detroit’s auto makers aren’t the only ones in Michigan seeking the government’s helping hand. The beleaguered state’s largest health insurer is looking for financial relief too.

Blue Cross Blue Shield Of Michigan wants state lawmakers to give it more leeway over how much it can charge for health insurance to offset losses the not-for-profit insurer says it has racked up as the state’s insurer of last resort, writes the WSJ this morning.

The proposal hasn’t gone down well with for-profit insurers and consumer groups, who claim BCBS of Michigan is exaggerating its financial problems.

Rival insurers don’t like a provision that would require them to pay a penalty for rejecting sick consumers who wind up with Blue Cross. Blue Cross isn’t taking that criticism lying down. “They don’t want to see Michigan change because they know it’s the last free ride,” Blue Cross’ Hetzel told the paper.

Meanwhile, consumer groups fear any future premiums hikes could boost the ranks of the uninsured.

State lawmakers are hammering out a final version of the bill. A vote could come later this week.

From the Wall Street Journal

BCBS of Michigan Tries to Pry Itself From Under Regulation

From the Kaiser Network:

Blue Cross Blue Shield of Michigan is urging the state Legislature to pass legislation that would give the insurer more flexibility in setting premium rates and reduce government regulation, the Wall Street Journal reports. The insurer said that without the changes, increasing per-member costs will lead to financial troubles. As the state's insurer of last resort, BCBS is exempt from $80 million to $110 million in state and local taxes annually in exchange for providing affordable health coverage to all applicants, including those rejected by private insurers. The firm claims that as more people in the state have lost their jobs or employer-sponsored insurance, the number of BCBS policyholders has doubled in the past two years. It says that because it cannot reject any applicants, its per-member costs are four times those of private insurers. BCBS says the company likely will have a $166.5 million loss on individual products in fiscal year 2008 and a $264 million loss in FY 2009.

In addition, BCBS is asking that other insurers be charged a "cherry-picking" penalty for rejecting applicants who end up with BCBS -- which would go to BCBS to help fund their coverage. A version of the firm's proposal was passed last year by the state House and another -- from which some of the more "dramatic" proposals were removed -- was passed this spring in the Senate, the Journal reports. A vote on a final version could be taken this week.

Other insurers, the Michigan attorney general and consumer groups have spoken out against the requests, saying the legislation would allow BCBS to charge higher premiums to sick customers and shirk its social responsibility. Richard Murdock, executive director of the Michigan Association of Health Plans, said, "This does nothing for Michigan's uninsured population, and it only raises the possibility of the worst-case scenario of higher premiums." State Attorney General Mike Cox (R) said that the firm is exaggerating its problems, noting that its reserves have increased by more than $2.96 billion from 2001 to 2007. He also said the firm has been able to cover its losses on individual products in the first nine months with other income and has recorded $110 million in profit (Fuhrmans/Martinez, Wall Street Journal, 12/4).

Local Doctors' Actions Reflect Nationwide Trend

by T.M. Shultz at the Daily Courier
Saturday, April 26, 2008

What primary care doctors are doing in the Prescott area reflects what primary care doctors are doing across the country.

They are:

• Retiring.

• Changing careers.

• Not taking new patients.

• Converting to cash-only practices.

• Refusing to accept new Medicare patients or dumping them when they reach a certain age or, in at least one case, opting out of the Medicare payment system altogether.

• Limiting the insurance they'll take to one or two major companies. In Prescott, it's typically Blue Cross Blue Shield and the Arizona Foundation for Medical Care, which is a provider network for Yavapai Regional Medical Center's employees.

Read Entire Article

In Delaware - Blue Cross must Pay Fines for Late Claims

Judge upholds $100,000 ruling by Del. insurance commissioner

The News Journal, April 26, 2008

A Superior Court judge has upheld a $100,000 fine against Blue Cross Blue Shield of Delaware, which the state insurance commissioner assessed last year after finding the company failed to process thousands of medical claims within a state-mandated time period.

The decision by Judge Peggy Ableman affirms a September ruling by Insurance Commissioner Matt Denn, which found that in the first six months of 2006, Blue Cross Blue Shield of Delaware, the state’s largest health insurer, failed to process 10,467 health insurance claims within the required 30 days.

Read Entire Article

Blue Cross spends big to promote legislation

BY PATRICIA ANSTETT • FREE PRESS MEDICAL WRITER • March 3, 2008

Blue Cross Blue Shield of Michigan has spent $1.1 million since Jan. 1 on TV ads in seven major Michigan cities to promote a legislative agenda that would allow the nonprofit to set its own rates for individuals buying health insurance policies.

The money bought more than 2,600 TV spots, airing as often as 10 times a night, usually in prime time, including pricier buys during "American Idol," "CSI Miami" and the late-night Jay Leno and David Letterman shows.

By comparison, Put Michigan People First, one of three coalitions of commercial insurers, HMOs and others opposed to the legislation, has spent $65,000 on radio and print ads, according to Mike Nowlin, a Lansing public relations specialist who serves as the coalition's spokesman.

Read Entire Article

Michigan Attorney General Pursues Investigation of Blue Cross

Michigan Attorney General Michael Cox sent a fax on Thursday night to Dan Loepp, president and CEO of Blue Cross Blue Shield of Michigan, asking Loepp to explain by June 2 whether the company violated state laws by purchasing a for-profit insurance company for one of its subsidiaries.

Crain’s reported Thursday that Cox was looking into allegations made Wednesday at the Michigan Senate Health Policy Committee that the Blues may have violated state laws in acquiring several out-of-state insurance companies.

In the letter to Loepp, Cox asked nine questions related to the Nov. 20, 2007, purchase of CWI Holdings Inc., the parent company of CompWest Insurance Co. in San Francisco.

Read Entire Article

Governor Schwarznegger joins opponents of Blue Cross Blue Shield rescission practices.

Blue Cross of California, BC Life, HealthNet, and other large California health care coverage providers have been accused of improperly dropping (rescinding) thousands of health insurance customers using an illegal practice called "post claims underwriting". They do little or no investigation when they issue the policy, but if you run up big bills they scour your medical records to find reasons to rescind your coverage based on alleged "misrepresentations" in a confusing and complicated application. The charge is that they loan you an umbrella and want it back as soon as it starts raining!

Now California's Governor has joined proponents of regulatory action and class action lawsuits in condemning this practice. According to the Sacramento Bee, Schwartznegger said it is "outrageous that innocent patients have to live in fear of losing their health care coverage. I look forward to working with my partners in the Legislature to ensure this egregious practice is stopped."

Read Entire Article

Hospital, Blue Cross Talks Stall

By ROBERTA FUGATE

from the New Jersey Herald

NEWTON — Newton Memorial Hospital patients insured by Horizon Blue Cross/Blue Shield received notice late last week that the hospital intends to terminate its contract with Horizon.

"It is the bigger picture that brings us to this point with Horizon. It is the environment of hospitals in the state," said Newton Memorial's Sean O'Rourke, chief operating officer. "Everybody in New Jersey is dealing with it."

The decision came about after several attempts were made by the hospital to negotiate a contract that would provide what it considers more appropriate payment rates for its services.

"This is not new," O'Rourke said, "We have talked with more than 20 insurance companies over the last 18 months. Getting to this point helps both parties focus on the task at hand."

The letter, signed by President and Chief Executive Officer Thomas Senker, stated, "Although this letter will alert Horizon of our intentions, Newton Memorial will continue to negotiate in good faith for rate adjustments to sustain high quality care and accessibility to modern and efficient health care facilities for you and your family."

Horizon Blue Cross/Blue Shield executives did not return phone calls seeking comment.

Under the terms of the current contract, the hospital is in-network with Horizon. The hospital said it will continue to negotiate rate adjustments so that it can sustain care and accessibility to health care facilities for its patients.

The contract states that those who subscribe to Horizon still will be able to utilize their in-network benefits at Newton Memorial Hospital for 90 days, until July 22. After that, Horizon members can continue to go to Newton Memorial Hospital to receive out-of-network services. The reimbursements will depend on individual health plans.

Patients who have HMO coverage will remain in-network for four months after the termination of the contract, until Nov. 22.

BCBS Round-Up

Let's get caught up on some of this weeks Blue Cross / Blue Shield stories.

Senate panel chief may trim Blues bills provisions
By Jay Greene

The Senate Health Policy Committee is expected Wednesday to vote on four controversial bills that seek to reduce premium rates and expand access in the individual health insurance market and give a for-profit workers' compensation insurance subsidiary of Blue Cross Blue Shield of Michigan the right to enter other insurance lines.

But in response to testimony the past two weeks, Sen. Tom George, R-Kalamazoo, who chairs the committee, said last week that he may drastically reduce the number of provisions in the proposed legislative package.

While Blue Cross opposes eliminating major portions of the proposed legislation approved last October in the House, George said he is inclined to push for the following:

Read Entire Article

AMA Committed to Enforcement of BCBS Settlement

The American Medical Association (AMA) announced that it will begin enforcement of the national Blue Cross and Blue Shield (BCBS) settlement as a signatory medical society to the agreement. The AMA joins 27 other participating medical societies that are able to provide direct assistance to physicians when a BCBS plan or subsidiary has failed to comply with the national BCBS settlement.

The AMA's participation in enforcement of the BCBS settlement was initiated yesterday when a Miami federal court finalized the settlement of a nationwide physician class action lawsuit brought against Blue Cross and Blue Shield Association and more than 30 affiliated plans and subsidiaries.

Read Entire Article

New Plan for Michigan Health Insurance Reform

From Our Own Detroit Free Press

State Sen. Tom George offers a well-thought-out plan for health insurance reform
April 6, 2008

On matters of public health, the State of Michigan's overarching goals must be improving it and increasing access to care.

With those guideposts, state Sen. Tom George, a physician, has a better plan for health insurance reform than one put forward by Blue Cross Blue Shield of Michigan and shot through the House last fall with disgracefully little review for an issue of such importance. George, a Republican from Kalamazoo, has, after a series of hearings he chaired in the Senate Health Policy Committee, produced his own set of proposals for the individual insurance market -- and they make sense.

Blue Cross, a not-for-profit agency set up through state law, has been lobbying for changes that the Blues say will enable them to be more competitive in the growing individual insurance market. At the same time, the Blues want less regulation and more freedom to invest in for-profit subsidiaries.

Read The Rest of New Plan for Michigan. . .

More on BC/BS of Michigan and House Bills 5282-5285

In a recent blog post, Jeff Emanuel discusses Michigan House Bills 5282-5285, pertaining to changes in insurance laws being pushed by Blue Cross / Blue Shield of Michigan. His introduction reads:

“In late 2007, after a single perfunctory committee meeting, the Michigan House of Representatives passed a series of four bills which, if approved by the Senate and signed into law by Gov. Jennifer Granholm, will have a very negative effect on the health insurance market in the state.”

. . . and later in his article he writes:

“Health care giant Blue Cross Blue Shield (BCBS) has long enjoyed tax-exempt status in Michigan, as the result of a 1938 deal BCBS made with the state to be the “insurer of last resort” for otherwise uninsurable consumers. This means, for tax purposes, that the carrier was treated as a non-profit corporation, while actually operating as a for-profit business.”

To read Jeff’s entire article, go to his blog-entry page.

Besides being a self-described “combat journalist,” Mr. Emanuel is a Research Fellow for Health Care Policy at the Heartland Institute (a free-market public policy organization) - and - the Managing Editor of Health Care News.

Is New Blue Cross Plan Bad for Michigan?

Blue Cross / Blue Shield of Michigan is trying to push a controversial insurance bill through the Michigan state legislature. Michigan attorney general Mike Cox is adamantly opposed to the bill, and he recently wrote an editorial expressing his opinion and his reasons. Here is that editorial. Please take the time to weigh in on this serious topic — the new bill could adversely affect Michigan’s elderly population and hamper the efforts of Senior Care Providers, Assisted Living Facilities, Adult Foster Care Homes, and Nursing Homes, to keep their clients in good health.

Published January 13, 2008 [ From Ingham County Community News ]

Blue Cross plan is bad for Michigan

by Mike Cox — Attorney General for State of Michigan

Michigan citizens could see dramatic changes to their health insurance rates and coverage if the legislature approves a package of bills being pushed by Blue Cross. If signed into law, House bills 5282-5285 will cause subscribers, especially the old, sick and most vulnerable, to pay much more for coverage or lose their insurance altogether, while fattening Blue Cross’ already profitable bottom line.

The Blues were created in 1939 and given a social mission; specifically, to be the “insurer of last resort.” As a result, Blue Cross was also made tax-exempt. By their own admission, this tax-exempt status benefits the Blues by at least $82 million each year.

And Blue Cross has done well. Their share of the commercial health insurance market in Michigan is 70 percent. Their surplus has more than doubled in the last five years, to more than $2.8 billion, the highest in history. Blue Cross makes more than a million dollars a day in profits.

Salaries are on the rise, too. According to data filed with state regulators, Blue Cross paid its top ten officers $11.5 million in salary and compensation in 2006 — that’s a 42 percent increase since just 2004.

Guess what else has been going up? Rates. Individuals seeking health insurance have seen their rates skyrocket by 79 percent since 2003. And for those folks who have converted from group policies, their insurance rates have shot up even more — a 92 percent increase since 2003.

Not surprisingly, these massive rate hikes mean that more and more Michigan citizens and families can’t afford insurance. The number of uninsured in Michigan has gone up 8 percent since 2001. And the number of people on Medicaid has ballooned by 38 percent in that same time period. The result: One out of every four Michigan citizens is either uninsured or on Medicaid.

But Blue Cross says that it is heading for a “death spiral.” So the Blues are pushing a package of bills that will do the following:

# Deny coverage of pre-existing conditions for 12 months, a doubling of denial time;

# Charge new customers with chronic diseases such as diabetes up to 80% more;

# Charge new customers with serious illnesses such as cancer up to 250% more;

# Enable the Blues to triple their margins for administrative expenses and profits; and

# Eliminate oversight by the Attorney General and the Governor’s Office of Financial and Insurance Services (OFIS).

Oversight is crucial. This year, Blue Cross sought a 50 percent hike on the premiums that seniors pay for Medigap insurance. I intervened, saving more than 215,000 Michigan seniors $97.5 million initially, and over $69 million per year after that.

These bills would also eliminate the Governor’s ability to provide oversight of rates, by eliminating the ability of the Commissioner of OFIS to set rates. As a result, all state oversight — the ability to intervene and fight for lower rates — for any of Blue Cross’s future rate hikes would, for all practical purposes, be wiped out.

These bills seriously jeopardize Blue Cross’ social mission to care for the oldest and sickest in Michigan, and they destroy the Attorney General’s mission to protect them. I call upon citizens to contact their state legislators and urge Blue Cross stay true to its traditional — and legally required — mission “to secure for al of the people of this state … the opportunity for access to health care services at a fair and reasonable price.”

Mike Cox is Michigan attorney general.