Category: Government Programs, Health Insurance

The Nature of Vigilance and Compromise

The Louisiana legislative session started a couple of weeks ago, so we thought it would be a good time to give you the Straight Talk on how Blue Cross is involved with the legislative process to help protect your health and your premium dollar.

I grew up with four siblings – two sisters and two brothers. If you can imagine seven people in a 1,400 square foot house with 1.5 bathrooms and one 30-gallon hot water heater, you’d know why there were a few conflicts among the kids. I was the oldest, biggest and a bit of a bully, no doubt (as my siblings still remind me today from time to time). But my parents, especially my mom, were expert negotiators and very skilled at keeping the peace.

For the first 15 years of my life, my dad worked offshore – seven days on and seven days off. Can you imagine the hell we put my mom through during those seven offshore days? But Mom was (and still is!) so smart, she had a knack for rapidly figuring out what was really important to us during an argument and “splitting the baby,” or compromising in such a way that we all found peace.

And, of course, when that failed, she would have to put in a very expensive, very messy radio-telephone call (this was like 1974, so no cell phones) to a rig to report our transgressions. Then if we were REALLY bad, we’d have to actually get on the phone and SPEAK to Dad, hear him explain his plan to us and then WAIT IN FEAR TIL HE CAME HOME! You can imagine that straightened us right up. But it almost never came to the phone call because Mom was so good at settling arguments and helping us compromise with each other. I always admired that peacemaker skill set, and she had it.

On Vigilance

It reminds me of our work here at Blue Cross and Blue Shield of Louisiana with our legislators and regulators. You probably don’t think about this much, but multiple legal bodies like the U.S. Congress, Louisiana State Legislature, Louisiana Department of Insurance, federal and state health, treasury and labor departments and a host of other empowered groups of people are constantly trying to change the rules we operate under. In the current legislative session here in Louisiana, more than 40 proposed pieces of legislation have been filed that could change your insurance coverage, raise your premiums or cause other things in your finances to change very rapidly.

As part of our mission to improve the health and life of Louisianians, we take our obligation to analyze such changes very seriously. I participate in national work groups, and have for 15 years, with other Blue Plan representatives. Together, we analyze potential changes coming to your health insurance from federal agencies in Washington, D.C. and U.S. Congress. Sometimes we get to weigh in and comment on them. I take those opportunities VERY seriously, because I am representing you and most of my family members when I speak on those topics. I am a Louisiana defender, and so I speak up for our state every chance I get.

Locally, we have dedicated teams of people who will analyze the Louisiana Legislature’s 40+ healthcare/health insurance-related bills filed for this session (so far.) I occasionally consult with our local legislative teams when a proposed bill concerns an area in which I have special expertise (like the coverage of GLP-1 drugs and the inherent costs, for example). It’s very important to me that you all know we are working hard and trying our best to speak for you, with two major goals:

1. To make sure our health insurance coverage improves your quality of life; and

2. To fight anything that will drive up your premiums, or your cost-sharing, without providing commensurate value to match this new (required) investment.

On Compromise

It is a quiet and often unseen job. But I, along with the teams of people here at Blue Cross focused on legislative affairs, work hard to help people in power have as much hard data as possible about the impact of any proposed changes so they can use that information to make decisions. Cost/benefit analysis is just the beginning, and it’s something at which I am really, really good.

Sometimes the changes are amazing, things we didn’t have the authority to do, and are better for everyone! In those cases, we dive right in and support such changes on your behalf.

Sometimes the proposed changes are CLOSE to being something that will improve your quality of life or affordability. Then, we work with the people in power to improve those suggestions and make the regulation or legislation more effective. This happens a lot, and we are happy to be part of that process.

Sometimes the changes are not good for either your affordability, value or quality of life, or serve only small constituencies pushing for a change at great expense to everyone.  In those situations, we let the decisionmakers know what the facts say, and we let them know what the impact on YOU, our members, will be if they pursue that course of action.

We do all these things because we feel at least partly responsible if your health insurance changes in a way you are unhappy with. We all want to wake up in the morning, look in the mirror and feel confident that we did everything we could have done to protect you, your coverage and the affordability of that coverage.

The Straight Talk is, we win some, we lose some; that’s the nature of the political game. But we never stop monitoring, studying and fighting for you. And change never stops coming in the current environment, so vigilance and compromise are the rules of the game.

Posted on: March 21, 2024

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