CA Attorney General To Investigate The Nation’s Two Biggest Health Insurance Companies

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GUESTS: Clarence Page, Markos Moulitsas, Rep. Maxine Waters, Jonathan Alter, Ana Marie Cox

KEITH OLBERMANN, HOST (voice-over): 
Good evening from New York.

The details and the panic in the town halls may be utterly artificial, but the fear is very real — fear of a change to, in particular, insurance. Fear that a modified system might result in — I don’t know — 22 percent of insurance claims being rejected or a third of them — or God forbid, 40 percent — 40 percent claim rejections would mean, if not death panels, and certainly bankruptcy panels.

Here’s the problem, those are the rejection rates now. Today, 22 percent of all claims in California, a third of claims made to CIGNA, 40 percent to the astroturf-funding United Health Groups specific care. Right now, right now — there are bankruptcy panels in California. Next.

Congresswoman Maxine Waters of California on how this wonderful system — the Republicans and the ordinary people they are terrorizing — is currently rejecting nearly a quarter of all insurance claims in her state. The same pretzel logic convincing right-wingers to force their kids to become truants next week.

In health news today, the group Consumer Watchdog has asked California Attorney General Jerry Brown to investigate whether the nation’s two biggest health insurance companies, included United Health Group, which we’ve reported on here before, broke state law by pressuring employees to oppose health care reform.

And in other health news today, California Attorney General Jerry Brown announced he’s now investigating possible wrongful business practices by his state’s five biggest health insurance companies, including one owned by the United Health Group.

Specifically — in our fourth story tonight: It turns out death panels are kind of real. And it took a group of nurses to find the real ones.

Brown’s investigation comes after the California Nurses Association analyzed state data and found that one in five medical claims there is rejected. United
Company PacifiCare rejected 39.6 percent of claims two- out-five. The insurance companies claim the figures are misleading although the data came from their own filings.

The state’s managed care agency said most rejections do not mean denying treatment. No, in those cases it just means denying reimbursement — which helps to explain why medical bills are a top cause of personal bankruptcy, meaning: we still don`t know the exact numbers who have had to go before insurance company death panels and have already died as a result.

PacifiCare, part of United Health Group told the "L.A. Times" its rejection rate had been inflated because it reflects internal disputes with physician groups that never affect patients. The state’s managed care agency told the paper, quote, "Department examiners are at the health plan right now reviewing its payment practices."

And the parent company, United, Attorney General Brown’s office says he is considering a request to investigate both United and WellPoint, both of which deny that urging their employees either to support bipartisan reform at best or
to explicitly, to oppose congressional bills, violates state laws against coercing employee political activity.

Let’s turn now to Democratic Congresswoman Maxine Waters of California.

Great thanks, once again, for your time tonight.

REP. MAXINE WATERS (D), CALIFORNIA: Delighted to be with you. Thank you for inviting me.

OLBERMANN: One investigation already underway in your state and another under consideration. Let me start with the denial of claims.


OLBERMANN: Is that a criminal investigation there, too?

WATERS: Well, I am so pleased that Attorney General Jerry Brown has decided to take this issue up. These stories we’ve been hearing for years. People who pay their premiums year in and year out, and then, when they file a claim, the war begins. They’ve got to fight. They`ve got to do everything to try and get these companies to pay, and then they’re often times rejected.

This information by the California Nurses Association is extremely important. This is a credible organization, representing over 86,000 nurses in the United States of America, and this finally put the facts before us — that with which we suspected all along that there were huge rejections.

This 39.6 percent of PacifiCare, that is outrageous. And then, they ask us to somehow compromise and have a trigger to let these insurance companies keep on committing these crimes and somehow set some kind of benchmarks to give them an opportunity to do right. They’ve been ripping off the taxpayers, the American people, the citizens of this country, for far too long. No compromise should be entertained by anybody.

OLBERMANN: Yes. And the idea was, we`re going to have triggers if the system doesn’t work. The point is.


OLBERMANN: … the system doesn’t work right now. We’ve already met whatever triggers could be established.

But let me ask you back about Attorney General Brown, with all due respect to what he’s trying to do. Does our nation’s health care problem, including the denial of claims, does that — is that owed more to the fact that sometimes laws are being broken? Or more to the fact that so much is actually legal and the insurance companies can get away with effectively murder?

WATERS: Well, the fact of the matter is, we don’t regulate them in ways that would even suggest what their rates should be, whether or not they are — should or should not be denying claims. This is all within their power to do. They can take someone again who`s been paying premiums for 10 or 15 years on time, regularly, in one of these HMOs, whatever you want to call it, and they can decide after they do their own review whether or not to reject or to deny. We don’t clearly have a lot of control over that.

OLBERMANN: We already know about the financial implications of this. And I hesitate again to use that incendiary term "death panels." But do people die, in fact, because of decisions made by insurance company executives?

WATERS: We absolutely have stories. We have information from people who have had the experience that there have been deaths. As a matter of fact, there are several that was cited by the nurses association as they presented this information about young people who have been denied certain procedures and consequently died.

OLBERMANN: This request for the inquiry into WellPoint and United, that they coerced employees to go and oppose health care. Even if they did, from the company’s point of view — so what? What could possibly happen to the companies that would outweigh the benefits of creating these kind of fake public testimonials against health care reform?

WATERS: Well, the fact of the matter is, if they have decided to treat their employees that way and to intimidate them and maybe even suggest in some ways that they may not continue to be employed if they don’t follow the company lie, it’s something that we ought to be investigating. We should not allow them to do that.

OLBERMANN: Congresswoman Maxine Waters of California — as always, great thanks for your time, and good luck as you continue your fight on this.

WATERS: Thank you. Thank you so very much.

Consumer Watchdog
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