North Carolina Blues lobbies voters against public option

North Carolina's BlueCross BlueShield-affiliated plan is the latest health insurer encountering a backlash for its lobbying efforts to thwart elements of health system reform.

Blue Cross and Blue Shield of North Carolina spokesman Lew Borman said the company is lobbying against a government-run health plan because it believes current proposals would result in increased premiums for Blue Cross customers.

"If we were not speaking out on these issues, North Carolinians could only be hearing from supporters of a government-run plan. We believe we have the right and responsibility to be involved in the debate and discussion," Borman wrote in an e-mail.

In October, the company sent mailers to registered voters urging them to contact U.S. Sen. Kay Hagan (D, N.C.), then followed up with prerecorded calls to those same voters, Borman said.

Not all recipients were happy to hear from Blue Cross.

The state's attorney general began an investigation into the calls following a complaint from an 82-year-old Tryon, N.C., man who wrote that the call he received Oct. 21 asked him and his wife to "influence Sen. Kay Hagan in a way that violates our beliefs."

The attorney general's initial assessment found that the calls violated state law. A Nov. 9 letter from the attorney general's office asked the N.C. Blues to immediately stop making calls.

Lawmakers question tactics

Meanwhile, North Carolina state legislators also heard complaints from constituents. Twenty lawmakers wrote to the attorney general and insurance commissioner Nov. 24 asking them to investigate whether the Blues plan broke any laws with its lobbying efforts.

The insurer "appears to be engaging in a blatant political campaign utilizing the premiums paid by their customers," the letter stated. "Even if there is no apparent violation of existing statutes, we think this is bad public policy that deserves further scrutiny."

North Carolina Insurance Commissioner Wayne Goodwin also has received multiple consumer complaints about the calls and mailings. He has asked Blues plan to respond to the legislators' letter, insurance department spokeswoman Kristin Milam said.

Borman said in his e-mail that the company is "cooperating fully" with the attorney general's office. As to whether policyholders' premiums were used to pay for the calls, Borman wrote, "This was a business expense."

The North Carolina Medical Society has not taken a position on whether the N.C. Blues plan should be lobbying voters. The society is opposed to a public health insurance option if payment rates are based on Medicare.

In a letter to its congressional delegation sent July 29, the society's president said a public plan "will perpetuate cost shifting to the private sector plans, which will destroy their competitiveness and drive all Americans into a government-run plan."

Blue Cross and Blue Shield of North Carolina is not alone in risking public criticism by lobbying voters to oppose part or all of the pending health system reforms.

Louisville, Ky.-based Humana did the same earlier this year and was criticized by Congress and the public. An inquiry into the company's lobbying prompted a backlash from Republicans who accused Democrats of trying to limit free speech.

Humana also was among dozens of shareholder-owned health care companies that are the subject of shareholder resolutions announced in November. The resolutions are sponsored by an investors' group, the Interfaith Center on Corporate Responsibility, and call on the companies to disclose the disparity between the salaries and benefits of its highest-paid executives and lowest-paid workers.

In a news release, the group noted that "among the insurers, medical device makers and other companies receiving the resolutions are many of the leading opponents of congressional action on health care reform."