Why Health Insurance Premiums Went Up

It didn't make sense. Why would a health insurance company make a decision to pay more for a drug? Then it hit me. It was for profit after all. I don’t know why I was so surprised. First off, I should tell you that I have a chronic condition that requires medication so that I can function. And it is pricy. So I also require health insurance in order to afford this medication. Since my husband is a small business owner and I am self-employed, we have to buy our own insurance. We have been on insurance through the ACA for about a year and a half. I previously was able to get my medication from Rite Aid, which the pharmacist told me cost about $2000 for a month's worth. This is when I had Blue Cross Blue Shield(BCBS) insurance through a group plan. But then that plan would no longer be available to us and we had to get insurance through the ACA. We chose BCBS as our provider but I noticed they created a subsidiary for use for the ACA, HMO Louisiana. With this insurance plan, they told me that I could only buy the drug through a specialty pharmacist, and not just any specialty pharmacist, CVS Specialty Pharmacist. When I received the statement showing what they spent, it cost about $4100 for a month worth of medication. This didn't make any sense to me. Why would they make the decision to spend more? Then I read about the MRL, the Medical Ratio Loss. This states that insurance companies can only make a certain amount of profit from the insurance premiums, that 80-85% has to be spent on medical care. So what they did was choose the most expensive way to pay for drugs so that they can increase the amount they can get from premiums and increase their profits. So everything is going up because their profits can only go up when they spend more money. There was a loophole and they found it and now its costing everyone more money. I'm sure because it is not easily explained but easy to hide in the details, most people won't know they are doing this. But it really needs to be addressed. In the meantime, if the legislators want to do actual good and get costs lower, they should write a provision to the ACA stating that it is illegal to drive costs up by artificial means...even while they are trying to dismantle it.