Massachusetts' secretary of state last week railed against three prominent not-for-profit HMOs, claiming they act more like for-profits and saddle citizens with "diminished care at higher premiums."
Declaring an emerging health insurance crisis, Secretary of State William Galvin said he can strip HMOs of their charitable status if they continue to shed benefits and coverage to save money.
Galvin issued a similar criticism in March and launched an investigation into Fallon Community Health Plan, Harvard Pilgrim Health Care and Tufts Health Plan. The plans had scaled back unlimited prescription coverage for the elderly, required by state law, after HCFA said changes in federal regulations barred states from imposing stricter benefits than required by Medicare.
The drug-coverage cutbacks have infuriated senior citizens, but the HMOs said they had no choice because of rising drug costs and big net losses in 1998.
A Sept. 9 editorial in the Boston Globe said Galvin was right to worry about how the elderly are faring but wrong to "criticize some of the best HMOs in the nation as if they were 19th-century robber barons. . . . Even nonprofit organizations will eventually go out of business if they keep posting losses."