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Anthem plan bridges the great divide

By Staff | Sep 20, 2013

The pigs have been cleared for takeoff.

Denizens of hell have ice scrapers at the ready.

And it looks like we’ll be admiring that sunset in the east after all.

Those are some of the things we thought we’d see before we ever saw traditional opponents on the abortion issue agree on anything. They are, historically, the lions and jackals of the rhetorical savannah.

But it happened this week, as if officials at the state’s only health insurance carrier needed more proof that their new slimmed down network of health providers is as unpopular as Lyme disease.

Officials at Anthem Blue Cross Blue Shield of New Hampshire got an earful of criticism during a meeting on Wednesday about their decision to cut 10 of the state’s hospitals out of their network – including Southern New Hampshire Medical Center in Nashua.

It’s important to point out that the new network – which takes effect Jan. 1 – will only apply to people who have purchased or will purchase individual health insurance policies from Anthem. If you get your insurance through a group plan at work, nothing will change.

But for those who don’t have that luxury, Planned Parenthood of Northern New England policy director Jennifer Frizzell worries that women won’t be able to get certain services at a Catholic hospital in the Anthem network – things like access to contraception, in vitro fertilization or other procedures.

“As a leading provider of and advocate for women’s health care services, we would have serious concern if New Hampshire women in any region of the state were limited to a health care network that does not offer the full range of reproductive health services,” Frizzell said in a statement.

Those on the other side of the abortion issue, like Ashley Pratte of Cornerstone Action New Hampshire, said access to health care is an overriding concern, especially when the network changes will force some people to switch hospitals and doctors that they’ve been seeing for years.

“Obviously, we are advocating for the pro-life community, but at the end of the day, you need to look at the family aspects of this decision to reduce hospital and doctor choice for women and their children,” Pratte said.

“I don’t understand how you can choose a hospital that doesn’t serve the full needs of women in a health center,” said state Sen. Bette Lasky, D-Nashua, who has been an advocate of women’s health services that include contraception and abortion.

“We didn’t just think we had to have them in Nashua,” Anthem CEO Lisa Guertin said. “We had to have them with access to Nashua.”

That’s a nice way of saying that, when it comes to certain types of care, patients may have to get in their car – if they have one – and drive to a place in the network that does offer the services they need.

This new network is a result of the Affordable Care Act. It came about after Anthem held private talks with the hospitals it decided to keep. As a result, hospitals in some cases reduced the prices they will charge Anthem for certain procedures by 25 percent. That, in turn, will allow Anthem to offer plans with premiums that are lower than they would otherwise be, Anthem officials say.

But to call the talks Anthem had with the hospitals a “negotiation” is probably not accurate, since that implies that the hospitals had a choice. We imagine an oversimplified version of the dialogue that took place might have gone something like this:

Anthem: “If you don’t reduce your prices for the procedures on this list, we’re going to cut you out of our network and force some of your patients to get treated at your competitor.”

Hospital CEO: “OK.”

Negotiation? Sounds more like a holdup.

But if Anthem can craft a plan that gets abortion defenders and opponents on the same side of an issue for once, perhaps we should enlist them for duty in the Middle East peace process. Or maybe even Washington, where Congress could use some help sorting out that debt-ceiling mess.

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