Lane S. Fulton
Seventy people have come to Indianapolis from across the country and recently risked arrest at Elevance Health headquarters. I was one of them. We were there for one simple reason: everyone needs health care, and private insurers like Elevance are making a killing by denying us care when we need it most.
Elevance renamed themselves Anthem Blue Cross Blue Shield in June. This new name reflects their desire, they say, to “elevate” and “advance” our health. Although Elevance has a dirty secret. Their record profits – $6.1 billion last year – are fueled by millions of denials of care to their own policyholders, like me.
I had six surgeries in three years at IU Health, Bloomington Hospital, and three of them were while I was covered by Anthem. During COVID-19, I got insurance through the Healthy Indiana Plan (HIP), which is part of Medicaid. I am now one of the 2 million Hoosiers who rely on this public program.
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Medicaid covered my subsequent surgeries. Then in the fall of 2020, I received a surprise letter from IU Health saying I owed $2,500 for old medical bills that Anthem had refused to pay. I was confused: I knew my Anthem policy had a deductible and I paid all the bills I received. I couldn’t afford this surprise bill.
So I immediately applied for financial assistance. A few months later, I received a letter from IU Health saying my medical debt would be forgiven. I was relieved and happy to tears.
Yet, a few weeks later, I received a letter from a debt collection agency, Harris & Harris, demanding that I pay even more―$5,000―for bills that Anthem still refused to pay, bills that I never received.
I was afraid. I was stressed. And I was angry. It seemed like IU Health and Anthem were working together to force me to pay even more.
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Private insurers like Elevance/Anthem want to suck our bones because denying care is easy money for them. Some private health insurers deny up to four out of five claims. They know our health care system is far too complex, so most people don’t fight their denials — in fact, only 0.2% of denied claims are appealed. But we are going to change that.
Those of us who showed up at Elevance headquarters are part of an effort called Care Over Cost. We help people who have been denied care by their insurance to appeal those denials and raise the issue that this practice by private insurers is unfair. Claim denials shouldn’t be a routine part of our lives that we just have to accept or face alone – instead, we show up for each other and face them together, so we can all get the care that we deserve.
Recently, we sent a letter to Elevance CEO Gail Boudreaux asking her to meet with us and asking Elevance to end its harmful practice of denying claims. We haven’t heard from Gail yet, but that’s okay ― we’ll be back. People like me are tired of being told by companies like Elevance that we don’t deserve quality health care. Because wherever we are and however we look, we all deserve better. We need health care that is there for us, every day, and not just when it suits the bottom line of a billion-dollar insurance company.
So Elevance, if you really want to “elevate” and “advance” our health, it’s easy: Stop denying our care.
Lane S. Fulton, a Bloomington resident, has a master’s degree in public administration, is a member of People’s Action, and works as an agency and safety net navigator, helping people access benefits like SNAP, TANF, the unemployment and health care.
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