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Regulation and Compliance > Federal Regulation

Big Insurer Fights Back in Court Against Regulation of Profit Margin (Kaiser Health News)

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Maine is in the regulatory spotlight this week, as a lawsuit challenging the state’s authority over health insurers’ profit margins draws national attention. Anthem Health Plans of Maine, the state’s largest health insurance provider, argues that regulators have deprived them of a “fair and reasonable return” for the past three years. The case echoes an earlier lawsuit in Oregon, where regulators cut a proposed 22 percent increase by BlueCross Blue Shield from 22 percent to 12.8 percent, saying the insurers’ growing profit margin was unfair to consumers.

It’s speculated that the case in Maine could have national repercussions: if regulators win, other states may be emboldened to monitor rate increases more closely; if they lose, insurers may be less subject to regulatory control.