Tell Blue Cross Blue Shield: Put Care Over Cost!

Blue Cross Blue Shield Association President/CEO Kim Keck and Elevance Health President/CEO Gail Boudreaux

People’s Action represents one million people in America–including hundreds of thousands of Blue Cross Blue Shield members from Connecticut to Colorado–most of whom have been harmed by their private health insurance company denying their care or a loved one’s care.

Over 91% of people in America are covered by health insurance and 76% of people in America have insurance through a private health insurance corporation. Unfortunately, private health insurance companies deny care for their members well over 248 million times annually. This averages out to more than once per covered member. Increasingly, the major barrier to people receiving care is not lack of health insurance but the private health insurance companies themselves.

Blue Cross Blue Shield (BCBS) covers 115 million people, likely making it the largest denier of care to people in America. BCBS plans have some of the highest denial rates on the ACA marketplace. BCBS greed helped create an epidemic of care denials within the private health insurance industry.

Tell BCBS to put care over cost!

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To: Blue Cross Blue Shield Association President/CEO Kim Keck and Elevance Health President/CEO Gail Boudreaux
From: [Your Name]

We are sick of the epidemic of claim and prior-authorization denials within Blue Cross Blue Shield (BCBS) plans and demand immediate change.

Under your management, BCBS care denials result in significant suffering for tens of millions of people annually in the form of medical debt, bankruptcy, ongoing sickness or injury, and even early death. Meanwhile, BCBS-affiliated companies rake in tens of billions in profits, while purchasing billions of dollars in shares to inflate prices and over-compensate executives. These profits are taken through inflated premiums from your members.

Here are some examples of how your profiteering hurts your members:

* Michigan United member Karl Schneider, a graduate student in that state’s Upper Peninsula, is experiencing gynecomastia. The condition is a rare side effect of an antidepressant. Karl was unable to get coverage for routine blood work as recommended by an endocrinologist and could not get coverage for surgery to mitigate the effects from his insurer Blue Cross Blue Shield of Michigan.

* Bri Moss, a leader of Iowa CCI, has had diabetes that was managed effectively for years with up to date insulin pumps. However, since Iowa privatized Medicaid, Bri has had insurance through Amerigroup, a subsidiary of Elevance (Anthem BCBS). Amerigroup refused to pay for a modern insulin delivery pump after Bri’s previous pump went out of date. As a result, Bri ended up in the emergency room over Thanksgiving of 2022. After organizing with Care Over Cost Bri won her modern pump and forced Amerigroup to pay, but not without substantial pain and suffering.

* Melinda, a Citizen Action of New York member from Syracuse - needed lab tests connected to chronic pain she was experiencing. Excellus BCBS misled Melinda that they would cover the tests but then stuck her with a $7200 bill.

* Mia, an ONE Northside leader, suffered for months without the essential migraine medication they needed because BCBSIL denied the medicine Mia's doctor prescribed.

BCBS members are staying sicker, longer, because your company and its affiliates are denying them medically recommended care. Meanwhile, you two are padding your pockets.

As CEO of the largest BCBS affiliated corporation, Elevance Health (formerly known as Anthem BCBS), Gail Boudreax led the company in taking more than $23 billion in profits and paying out more than $4.49 billion in cash dividends from 2017 through 2021. You personally took $19,348,241 in compensation in 2021 and you stand to take $59 million in a golden parachute if you are terminated even if for “good reason” as defined by the company.

Other BCBS plans within Kim Keck’s association are equally as guilty of profiteering as Elevance. For example, Excellus BCBS took $117.9 million in net income–profit–in 2021 and paid its top four executives over $1 million a piece. The Health Care Services Corporation (HCSC which oversees BCBS of Illinois, Montana, New Mexico, Oklahoma, and Texas) took $3.8 billion in net revenue–profit–in 2020 alone. In 2019 HCSC paid 10 of their top executives a combined $73 million. Blue Cross Blue Shield of Michigan took $360 million in net revenue–profit–in 2021 and its CEO took $15.6 million in compensation.

Your profiteering from care denials is a disgrace. We demand you immediately:

- Stop denying claims and overturn any existing denials for treatments recommended by medical professionals;

- Provide transparency around denied claims/prior-authorizations by market, state, geography, gender, and race;

- Share the monetary value of total denied claims/pre-authorizations broken down by internal and external appeals processes and total percentage of profits taken by denying care for their members;

- Hold monthly open-microphone meetings with policyholders to discuss problems with your insurance products;

- Relinquish ownership of and transfer over the claim and appeals process to relevant public authorities; and

- Reverse the specific care and claim denials in the cases from New York to Missouri listed above.

We take extremely seriously the harm your corporations are causing us and people in our communities. We await your timely response through an agreement to meet with People’s Action leaders in-person or over a video call to reply to these concerns or a written explanation of changes you will make.