Andrew Stolfi, Oregon’s newest insurance commissioner, started far afield from insurance, finance and health plans.
“It was a long journey to get there,” he said in an interview this week with The Lund Report. “In college, I majored in wildlife biology -- I wanted to study bears for a living.”
But he said he has always had a thirst for public service, making the switch from conserving large ursine mammals to protecting consumers not as difficult as it might seem.
The New York City native, who grew up in Pennsylvania, worked as a public prosecutor for the city of Chicago after attending law school there, and later moved up in Illinois state government, briefly serving as acting Illinois insurance commissioner under Gov. Pat Quinn.
“The director of the department was friendly with [Illinois U.S. Sen. Dick] Durbin’s office, and we were actually able to contribute to drafting and giving input on the development of the Affordable Care Act and fix the system in Illinois, which was fairly dysfunctional,” he said.
From there, he went to Switzerland for six years, working at the International Association of Insurance Supervisors, the global body for developing insurance standards for nearly every country.
The opening in Oregon gave him a chance to return to the United States with his young family and preside over an agency he considers to be one of the most progressive insurance regulators in the nation.
“In Illinois, we would look to Oregon … as a leader in the healthcare arena. Rate review is the perfect example. That’s something that has been in place [here] for many years -- not in place in Illinois -- which is a state that could really use it,” Stolfi said. “We would look to Oregon as a progressive state with really good ideas about what to do. A much more recent example is the reinsurance program … now Oregon is one of only a handful states that has one in place. It’s already up-and-running and other states are trying to play catch-up.”
Stolfi praised the work of his predecessor, Laura Cali Robison, who now serves as chief financial officer of the Oregon Health Authority. She spearheaded the reinsurance program, which taxes all health insurance policies upfront to help create a fund that insurers will be able to access to offset the cost of members with high medical costs.
2019 Rates Due Next Month
Stolfi said consumers should expect the reinsurance program, which held down individual health insurance increases by about six percentage points last year, to have a similar effect on 2019 health plans.
He otherwise offered few clues about the 2019 rates, which insurance carriers must submit next month for approval in the individual and small group markets. The Department of Consumer and Business Services will approve or modify the requests over the summer..
“I’m looking forward to being involved in it for the first time myself. It’s a very in-depth process,” he said. “I’m just as eager as most folks to know what’s going to be filed in mid-May.”
Recent Oregon trends should prevent health insurance carriers from pushing up premium costs too much. After losing $217 million in 2015, carriers lost $35 million in 2016 before reporting a $195 million surplus last year, Stolfi said.
”That’s the right way for the trend to be going. That’s the market and carriers improving and shoring up their reserves,” Stolfi said. “We’d like to see that translate next into better rates for consumers.”
But just as the market stabilized, the Republican Congress voted in December to eliminate the tax penalty for not buying insurance. Experts fear that could encourage people to leave the market, particularly young, healthy people and those who don’t qualify for subsidized coverage. Oregon rates were increased last year by 2.5 to 5 percent to account for the riskier individual health insurance pool.
So far, consumers haven’t fled the online health insurance marketplace, which has slightly more people enrolled for 2018 than in 2017. But consumers are still on the hook for the tax penalty until next year when it will disappear.
In 2019, the reinsurance program will likely be up for renewal in the Legislature, since the insurance tax that funds the program was only approved for two years. Stolfi said the cost of renewing the program may be lower than allowed in the 2017 legislation because Oregon received more than twice as much money from the federal government as anticipated.
The federal government supports reinsurance programs because they lower the cost of premiums and that, in turn, lowers the amount of money the feds must spend to keep premiums affordable for consumers under the Affordable Care Act.
Grant Could Help Rural Oregon
Stolfi is also looking at a possible rating reform. He said Oregon’s Division of Financial Regulation has submitted a grant application to the Centers for Medicare & Medicaid Services to fund an overhaul of the state’s geographic rating system.
Oregon currently has seven geographic rating areas, which may be too many, and Stolfi said some of the boundary lines no longer make sense, such as placing Hood River County in with eastern Oregon, including faraway Malheur County.
“We want to take a look at whether any of those areas can be changed, combined, what have you, with a focus on seeking out ways that we could increase access to insurance in rural Oregon,” he said.
Other odd choices put Deschutes County in the same area as Klamath and Lake on the California and Nevada border, but not Jefferson and Crook in central Oregon, which like Deschutes, are served by the St. Charles Health System.
Reach reporter Chris Gray at [email protected].