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Blue Cross Blue Shield of North Dakota draws heat for mailing

FARGO -- A letter Blue Cross Blue Shield of North Dakota is sending to its members about the possible cost of health care reform is drawing criticism from reform proponents.

The Blues are sending letters to members detailing the possible impacts health reform pending before Congress could bring, including premium increases.

"It was from the perspective that we have an obligation to keep our members informed of a potential impact of a premium increase," Blues spokeswoman Denise Kolpack said Tuesday.

The letter, which is included in a mailing it is required to send to members concerning women's cancer coverage, is going to 215,823 households, reaching 427,000 members.

The Blues letter includes a subheading, "Any public option is bad for North Dakota."

The public option would provide an alternative to private insurance as a means to spur competition to restrain costs.

The U.S. House was considering a public option that would be tied to Medicare payments to providers - a plan health providers and insurers agree would drive up costs to private payers and hurt the financial health of hospitals.

Rep. Earl Pomeroy, D-N.D., opposed a public option tied to Medicare reimbursements, which was not in the reform bill that recently passed the House. Support for a public option is weaker in the Senate, which has yet to pass its version of reform.

Don Morrison, a proponent of a public option and executive director of, said the Blue Cross Blue Shield letter exaggerates the costs of health reform.

The letter assumes very high participation in a public option, 30 to 50 percent. Those conversion rates from private insurance are much higher than the 2 percent estimated by the Congressional Budget Office, Morrison said.

"It's full of inaccuracies, exaggerations, sleights of hand," he said.

Kolpack said the Blues stand by the accuracy of figures in the letter, saying they were drawn from the company's actuarial analysis and other reputable sources, including the North Dakota Healthcare Association's estimates of the impact of a public insurance plan tied to Medicare payments.

"We have been consistent and factual in all of our information regarding proposed health care reform legislation and have not distorted any facts," she said.

Adam Hamm, North Dakota insurance commissioner, said the Blues are entitled to communicate with policyholders about the potential effects of health reform.

"What the policyholders do with that information is obviously up to the policyholders," Hamm said, adding that his office has not received any formal complaints about the letter.