Bradley attorney Dan Murphy was quoted in the Birmingham Business Journal on the effect of COVID-19 on health insurance providers.
Murphy said one big question is how the reduction in costs insurers are paying out as patient volumes decline balances out with all of the emergency care being provided.
Depending on the duration of the outbreak, Murphy said with many patients not getting anything but their standard emergency care, there could be a lot of pressure and scrutiny on the insurers to see whether they are seeing a windfall due to the reduction in patients seeking non-emergency care.
“Basically, they set their premiums on assumptions that are no longer realistic,” Murphy said. “So first of all, (there will be) scrutiny, but then secondly, if it does look like their medical loss ratio is not nearly as high as anticipated when they set the premiums. I think you can expect a tremendous amount of pressure on the insurer to give rebates back to the insured, and I think that would be, you know, both kind of public relations pressure, and even potentially legislative pressure and pressure from the administration.”
Murphy said the current administration is not shy about putting pressure on insurance companies to do different things during this crisis.
“One thing we’ve seen is that the administration will make statements or apply pressure on the insurance companies to do things like waive co-pays and cost-sharing for COVID-19 testing,” He said. “I just have to think that if there’s any evidence that the insurers made a much larger margin on their patients just because of this situation and the lack of non-emergency work. I have to think that, one way or another, either by their own decision or because they’re under pressure. Now, they would have to consider… a refund, a rebate or, adjustments in the future.”
The original article, “What Will COVID-19 Mean for Alabama Health Insurance Premiums?,” appeared in The Birmingham Business Journal on May 5, 2020 (login required).