A Superior Court judge on Monday rejected a request by six major health insurers to delay the rejection of hundreds of proposed small business premium hikes by the state insurance commissioner, Joseph Murphy.
An injunction would have permitted the health plans to implement premium increases for tens of thousands of small businesses ranging from 8 percent to 32 percent, levels the Patrick administration has targeted as prohibitive to job creation and in excess of underlying medical inflation rates.
The decision, announced just after 3:30 p.m. Monday, came as a victory to Gov. Deval Patrick and as a blow to the carriers, who said the inability to charge higher premiums to small businesses could destabilize the insurance industry and force companies to absorb losses totaling more than $100 million over the next eight months, depleting their reserves.
“We are disappointed that the court denied our motion for preliminary injunction, but we appreciate that the court has acted quickly in making its decision. We remain confident in the merits of our case and plan to consider all of our available options in light of today’s ruling,” the Massachusetts Association of Health Plans said in a statement.
The Patrick administration has hailed the rate rejections as immediate relief for small businesses who have been slapped with double-digit premium increases in recent years. Murphy rejected 235 of 274 proposed small business premium hikes on April 1. The rejections came after Patrick, in a sharp shift towards rate regulation that his political opponents labeled a gimmick, announced in February that any premium increases “significantly” above the 3.2 percent rate of medical inflation would be rejected.
“I appreciate the court’s decision. It’s a welcome decision for small businesses and working families who need immediate relief from excessive and unreasonable increases in their health care costs,” Patrick said in a statement issued shortly after the ruling was made public. “We look forward to working with the insurance companies, as well as hospitals and other providers, to secure this short-term relief, and to working with the legislature on proposals to reduce costs throughout the industry.”
Patrick’s Republican opponent Charles Baker blistered the governor in a subsequent statement.
"Despite today's ruling by the Suffolk Superior Court, nothing changes the fact that Deval Patrick has spent three and a half years taxing and spending small businesses into the ground, while failing to implement any solutions that address the underlying causes of skyrocketing healthcare costs under his watch,” said Baker, who stepped down as the head of Harvard Pilgrim Health Care last year to run for governor.
Speaking with reporters, Patrick admonished Baker, saying he should “stop playing politics.”
“It would be great to have him lend a hand,” he said.
In quashing the injunction request, Judge Stephen Neel endorsed the state’s argument that insurers failed to pursue all their administrative options before filing suit. According to Division of Insurance regulations, carriers can appeal rate rejections within 15 days of the ruling. As of Monday afternoon, three of the six insurers participating in the suit – Harvard Pilgrim Health Care, Blue Cross Blue Shield of Massachusetts and Tufts Health Plan – had appealed.
The other three insurers, Health New England, Neighborhood Health Plan and Fallon Community Health Plan, haven’t appealed, although each had dozens of premium hikes rejected.
Neel, who was appointed to the Superior Court by Republican Gov. William Weld in 2002, also rejected the insurers’ contention that they will suffer “irreparable economic harm” in the short-term, as a result of rate rejections.
“The Court reaches that conclusion because … the plaintiffs’ supporting affidavits do not present compelling evidence that the Plans’ business will be irreparably crippled over the next few months if injunctive relief is denied,” Neel wrote in his ruling. “[T]o the contrary, the Commissioner has demonstrated that one measure, calculated by the Plans themselves, indicates that the reserves and solvency of the Plans are stable, and should continue to be so in the near term.”
“As the Court has ruled above, whether the Commissioner’s disapproval was validly exercised should be determined on a factual record to be developed before an administrative hearing officer,” Neel concluded. “Were the Court now to grant the injunction which plaintiffs request, the Court would in effect be weighing in on issues that should in the first instance be decided by that hearing officer. The orderly process which Massachusetts law provides for administrative review, followed if necessary by Court review, will in the Court’s view best serve the interests of the parties and of the public.”
Insurers maintain that their proposed hikes reflect increases in the cost of medical care and have been approved by actuaries. They argue the commissioner overstepped his legal authority in rejecting the rates and by proposing to tie any rate increases to the cost of medical inflation. Although their injunction request failed, the lawsuit against the commissioner will continue.
Murphy rejected the premium hikes on the grounds that they were “excessive” and “unreasonable.” Insurers dismissed the rulings as a political ploy in an election year.
During last week’s court hearing, the insurers’ lawyer, Dean Richlin, alleged that the insurance commissioner agreed to approve any proposed rate hikes below 7.7 percent. Insurers said that proved Murphy was imposing an “arbitrary” cap on insurance premiums, while small business backers said it showed the commissioner was being flexible.
Insurers have repeatedly targeted the “market clout of certain providers” as a principal cause of rising health care costs. Reports from the Patrick administration’s Division of Health Care Finance and Policy and Attorney General Martha Coakley’s office have found that providers like Partners HealthCare command higher rates for services that other hospitals and community health centers perform at a much lower cost with no difference in quality.
“Health insurance premiums and medical costs are inextricably linked,” according to the MAHP statement. “An increasing portion of the premium dollar is attributed to the cost of medical care, with four of the five major health plans experiencing operating losses last year. Making health care affordable needs to start with addressing the market clout of certain hospitals and physician groups that was identified in the Attorney General’s recent report on health care costs and health care cost trends; otherwise, the cost of health care will continue to rise.”
The Division of Insurance has called for health plans to refund or credit to small businesses premiums paid at a higher rate in advance of the rate rejections.

