Clinton promises health insurance merger scrutiny in plan

Hillary Clinton said she would give close scrutiny to health-insurance industry mergers like those proposed this year by Anthem Inc. and Aetna Inc., part of the Democratic presidential candidate’s latest policy plans.

Clinton’s campaign, which on Tuesday released a group of policies intended to lower Americans’ prescription drug spending, said Wednesday that she would give families tax credits worth as much as $5,000 to help pay for all out-of-pocket health-care costs, while individuals would get as much as $2,500.

The credit would be available for those who spend in excess of 5 percent of their income on health care, and would be paid for by “demanding rebates from drug manufacturers and asking the most fortunate to pay their fair share,” her campaign said. Clinton’s drug cost proposal caused a slide in health-care stocks on Monday, sending the NASDAQ Biotechnology Index down 4.4 percent after she said on Twitter that she would release a plan.

She also called for health insurance reforms that build on what’s already in the Affordable Care Act, also known as Obamacare.

Out-of-pocket costs

“When Americans get sick, high costs shouldn’t prevent them from getting better,” Clinton said in a written statement. “With deductibles rising so much faster than incomes, we must act to reduce the out-of-pocket costs families face. My plan would take a number of steps to ease the burden of medical expenses and protect health-care consumers.”

The campaign cited a report released this week by the Kaiser Family Foundation that showed patient deductibles were rising faster than the cost of buying health coverage.

Clinton’s campaign also promised to “vigorously enforce antitrust laws to scrutinize mergers and ensure they do not harm consumers,” mentioning insurers as well as doctors and hospitals that sell them services.

Deals announced this year will consolidate the health insurance industry’s top five companies into three. In July, Indianapolis-based Anthem agreed to buy Cigna Corp. for about $54 billion, and Aetna struck a $35 billion deal for Humana Inc. Anthem’s and Aetna’s CEOs told lawmakers on Tuesday that the deals would benefit consumers and are necessary to succeed in a changing health-care landscape.

Clinton also would create a process for states that don’t have the authority to block or modify health insurance premium increases to stop what the campaign called “unreasonable” rises in rates.

Higher deductibles

Consumer costs are becoming the focus of the campaign’s proposals, prompted in part by changes that have companies asking workers to pay a greater share of the cost of coverage. The deductibles that patients pay before insurance kicks in climbed about 9 percent this year, and workers now pay an average of $1,077 a year in upfront medical costs for a single-person plan, according to the Kaiser report.

Clare Krusing, a spokeswoman for the insurer lobby America’s Health Insurance Plans, said consolidation by doctors and hospitals “drives up costs and insurance premiums for individuals across the country.”

“We first need to address underlying prices for medical services and repeal costly taxes,” Krusing said. The Affordable Care Act is partly funded by taxes on health insurance companies.

Monthly limits

Since 2010, health insurance deductibles have grown 67 percent, while premiums are up 24 percent, according to the report, which was conducted with another research group, the Health Research & Educational Trust.

Clinton’s drug-cost plan would limit patients’ out-of- pocket spending on pharmaceutical treatment to $250 a month, or $3,000 a year. Obamacare limits total out-of-pocket medical spending to $6,600 a year for an individual and $13,200 for a family.

Clinton also would give patients three visits to a doctor for illnesses without having to meet their health insurer’s deductible first, expanding on a provision in Obamacare that requires insurance companies to offer preventive health-care services, like flu shots and annual physicals, without cost- sharing.