About 95,000 policyholders could make a decision that will impact the health care of 1.9 million Blue Cross Blue Shield of Louisiana (BCBSLA) members, almost half of the state’s 4.6 million population. Monday, local legislators drilled down into the proposed sale of BCBSLA, a local nonprofit to Elevance Health, formerly Anthem, one of the largest national for-profit insurers.

Senate Chair Patrick McMath called it one of the most important decisions in regard to the health care of Louisiana for perhaps a very, very long time.

The committees issued a report Thursday of 30 findings described as concerning. “The regulatory process and vote steering, the troubled history of Elevance Health and the redirection of $3.1 billion from the policyholders to a new foundation, the Accelerate Louisiana Initiative,”according to the news release.

The committee has no formal role in the approval or disapproval.

Senator Patrick McMath, chairman of the Senate Committee on Health and Welfare, said after the almost eight hour session, “I am more convinced than ever that this is bad for the 95,000 policy holders who do get to vote, the 1 million who do not get to vote and the 35,000 health care providers in the Blue Cross network, the 2,500 blue Cross employees, and honestly the 4.6 million people who live in Louisiana.” He called the voting process, “one-sided.”

State Treasurer John Flemming, MD, chimed in with the Louisiana State Medical Society. A member of that organization spoke at the Monday hearing that represents family physicians, obstetricians and gynecologists, pediatricians, eye doctors and surgeons, orthopedic doctors, psychiatrists, pain physicians and plastic surgeons.

In his news release, Fleming said he spoke with someone in the Society who told Fleming what happens when Elevance has taken over mutual insurance companies in other states. After two years problems develop. Jobs are absorbed or moved. Doctors notice lower or not growing reimbursements. Premium rates accelerate. Patients complain that coverage for care is too often delayed or denied altogether.

Elevance has promised not to lay off workers for the first two years, and responded to Fleming’s letter.

“It’s unfortunate that Louisianians continue to be subjected to misinformation about the agreement between Blue Cross and Blue Shield of Louisiana and Elevance Health. The record is clear. Elevance Health is a trusted source of health coverage to more than 47 million people across the country while Louisiana ranks dead last by almost any public measure in healthcare. Louisiana can’t afford to let special interests who benefit from the status quo stand in the way of better healthcare, better health outcomes and a future that includes continued blue leadership in the Bayou State.”

On Feb. 14 and 15, a public hearing will be held on the reorganization and demutualization of Blue Cross Blue Shield. Senators asked Elevance and Blue Cross to bring the detailed answers to questions not provided Monday. On Feb. 21 is the Blue Cross policyholder meeting to vote on the deal. Blue Cross will need a two-thirds vote for the deal to go through. That means two-thirds of the votes collected, not a full two-thirds of the 95,000 voting members. If two-thirds of the votes are “against” the sale, the deal doesn’t go forward. If two-third of the votes are “for” the sale, the Insurance Commissioner gets to make the call between the vote and Feb. 29.

In at least three states, Insurance Commissioners have given a thumbs down to similar moves by Elevance to acquire Blue Cross, according to local, retired (for the most part) attorney John Bradford.

In 2022, a federal judge ruled that Elevance Health (formerly Anthem) must face a lawsuit the federal government filed that alleges its failure to identify and remove inaccurate coding as part of its charge review program. Elevance is one of the nation’s largest providers of Medicare Advantage plans for seniors. The total amount Centers for Medicare and Medicaid Services allegedly overpaid to Elevance could total more than $100 million.

“Do you want your insurer to be a company under investigation by the federal government for fraud,” Bradford  asked.

Of the 95,000 voting policy holders, 40,000 are insured through Medicare, according to testimony from Chris Alexander, Louisiana Citizen Advocacy Group. Alexander said some of these voters pay $300 a month for their Medicare. The $3,000 that voting members will get if the vote goes through could mean a lot to them.

Blue Cross said that they do not know how many proxies have been turned in. Votes can be submitted by mail or online. Some have been solicited by phone call. Voters can change their vote up until February 21.