Judges’ comments:
Duke Helfand of the Los Angeles Times, whose stories about the huge rate increases that Anthem Blue Cross sought to impose on individual policy holders in California in 2010 had an immediate impact on the national health care debate at a critical juncture, vividly illustrating the problems faced by Americans who lack employer-sponsored health insurance. They also had a measurable impact in California, helping produce rate reductions for policy holders as a result of the work done by an independent actuary whom Helfand profiled.
1. Provide the title of your story or series and the names of the journalists involved.
Anthem Blue Cross of California beat coverage, Duke Helfand.
2. List date(s) this work was published or aired.
Feb. 5, April 30, July 16, Aug. 10, 2010
3. Provide a brief synopsis of the story or stories, including any significant findings.
In January 2010, I took on a new assignment for the Los Angeles Times, covering healthcare for the newspaper’s business section. One of my first stories told how insurance giant WellPoint Inc. posted an eightfold increase in profit in just three months. Within days, I began hearing from irate customers of WellPoint’s California subsidiary, Anthem Blue Cross. They complained about huge rate increases that were arriving in the mail. I tracked down dozens of rate-payers up and down California and collected their insurance notices. I contacted half a dozen insurance brokers to corroborate the increases. A Feb. 5 story that began with old-fashioned beat reporting made its way to the White House and Congress. One figure, 39 percent, came to symbolize all that was wrong with a health insurance industry that stepped on people with no power. The figure was the highest rate increase I had found and focused national attention on the issue of insurer excesses and gave President Obama the prize he was looking for as he tried to restart his stalled health care bill. The other week, men and women across California opened up their mailboxes to find a letter from Anthem Blue Cross, Obama said in one of his weekly radio broadcasts as he geared up for a health care summit with Republicans. The news inside was jaw-dropping. Meanwhile, lawmakers in Sacramento and Washington launched investigations into the rate hikes and summoned top executives from Anthem and WellPoint to testify. Nine days after the story broke, Anthem bowed to pressure from California’s insurance commissioner to delay its rate hikes for two months. I followed this initial reporting with stories about flaws in Anthem’s rate application. The math errors were uncovered by an independent actuary hired the state, and they forced Anthem to cancel its hikes altogether. In the end, Anthem wound up delaying for six months and settled for about half of what it had originally sought, which saved California consumers about $150 million in premiums. Anthem’s president lost her job as a result of the controversy. And state regulators decided to examine rate applications submitted by three other major insurers: Blue Shield of California, Aetna Inc. and Health Net Inc. Aetna and Health Net soon had to correct flaws in their own paperwork. The three insurers were allowed to proceed after facing their own delays, costing the companies about $50 million in premiums.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I based these stories on correspondence between Anthem Blue Cross and its customers. I persuaded numerous policyholders to fax or e-mail me notices they had received from the insurer. I used the documentation to track the problem around the state and to determine the extent of the increases. Anthem would not comment on the size of the rate hikes or the numbers of people affected. For the numbers, I turned to the California Department of Insurance, which had the information in its files and provided it after some persistent prodding. Once my first story landed, hundreds of Anthem customers began to contact me. They wanted to speak out and be heard in the newspaper.
5. Explain types of human sources used.
I relied on many Anthem policyholders. I also developed sources within the company who were angry about the rate hikes and the publicity they had generated. These workers were willing to talk to me about the atmosphere inside the company and to guide me as the story unfolded. A couple employees in particular provided me with a blow-by-blow view of the firing of Athem’s former president, Leslie Margolin. After she left the company, Margolin and I established a constructive relationship. She also became — and remains — an important source for me about health insurance in California.
6. Results (if any).
The coverage of Anthem Blue Cross saved California consumers about $200 million in health care premiums. It also set the stage for more aggressive regulation at the state level. As a result of the stories, the Department of Insurance began to publicly disclose insurers’ rate filings on its website, giving consumers and the media important new information about how insurance costs are calculated. Until this time, all of this information had been treated as confidential.
7. Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
We ran no corrections on these stories. No one has challenged their accuracy.
8. Advice to other journalists planning a similar story or project.
Don’t accept the word of large companies. Be creative in how you report. Think of alternative sources, in this case, insurance brokers, regulators, lawmakers and consumers themselves, who can each provide a piece of the story. It’s the reporter’s job to assemble these pieces into a single, coherent article.