Exclusive: Obamacare’s Failed New York Co-Op Drew Most Consumer Complaints
Health Republic of New York, the largest Obamacare co-op in the country, was ranked as the worst health insurance company in complaints in 2014, according to the New York State Department of Financial Services.
State regulators ordered Health Republic Friday to stop writing insurance policies as it was no longer qualified to provide health insurance policies under New York state standards. Health Republic is the sixth of 23 health insurance co-ops funded by Obamacare since 2011 at a cost of $2.4 billion.
Federal officials and co-op advocates said the publicly funded insurers would provide better consumer service than profit-driven private companies.
Under Obamacare, the Centers for Medicare and Medicaid Services gave $355 million in low-cost loans to Health Republic, which included an emergency solvency loan of $91 million in September 2014.
New York’s DFS releases a consumer guide to insurance companies operating in the Empire State. Of the 12 health insurance companies considered as an exclusive or preferred provider organization, Health Republic ranked last.
State insurance regulators found that Health Republic had the highest number of consumer complaints upheld by DFS and the highest “complaint ratio” among the 12 providers in the category. The consumer complaints involved problems involving prompt payment, reimbursement, coverage, benefits, rates and premiums.
Health Republic also commanded the field as the insurer with the most grievances. DFS describes grievances as “a complaint by a member or provider to a health insurance company about a denial based on limitations or exclusions in the contract.”
DFS reported 6,801 grievances filed against the Obamacare co-op in 2012 and noted that 2,405 were reversed. In contrast, the second highest grievances among all other insurers in its category were 4,850.
DFS also reported that Health Republic had the second highest reversal rate. Fifty-three percent of all Health Republic grievances were reversed.
New York liberal political activist Sarah Horowitz founded Health Republic under Obamacare.
She received a total of $517 million in federal loans to operate health co-ops in New York, New Jersey and Oregon.
Horowitz previously ran another nonprofit health insurance company, Freelancers Insurance Company. She led that company immediately before being rewarded with the federal Obamacare loan money for Health Republic.
DFS ranked Freelancers health insurance company as the worst in consumer complaints two years in a row, from 2012 to 2013.
Horowitz dissolved Freelancers after receiving federal funds to create the Health Republic of New York.
Grace-Marie Turner, president of the free market Galen Institute and a critic of the co-ops said one of the critical mistakes in the Obamacare law was that it barred anyone associated with commercial insurance companies from participating in the co-op program, with a result that the co-ops could not recruit experienced health insurance professionals.
“You cannot have on your board anyone with ties to the insurance industry,” Turner said. “You basically have people on the board and in many cases running these organizations that do not have any experience in running an insurance company.”
Turner said the Obamacare co-op program became “on-the-job training” at the cost of $2.4 billion in taxpayer money. “A grand experiment that has not worked,” she said
Health Republic did not respond to a request for comment.
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