AXIOS: Anthem Blue Cross Blue Shield Calls Off Surgery Anesthesia Cap

By: Nathan Bomey | December 5, 2024

A major health insurance company is backing off of a controversial plan to limit coverage of anesthesia, according to public officials.

Why it matters: Anthem Blue Cross Blue Shield recently decided to "no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes," according to the American Society of Anesthesiologists, which opposed the decision.

  • The decision covered plans in Connecticut, New York and Missouri.
  • The insurer had based the move on surgery time metrics from the Centers for Medicare and Medicaid Services, NPR reported.

Friction point: The decision was controversial at the time — but outrage erupted this week after the murder of UnitedHealthcare CEO Brian Thompson in New York City cast a spotlight on divisive insurance decisions.

The latest: "After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I'm pleased to share this policy will no longer be going into effect here in Connecticut," Connecticut Comptroller Sean Scanlon said Thursday on X.

  • "We pushed Anthem to reverse course and today they will be announcing a full reversal of this misguided policy," New York Gov. Kathy Hochul said Thursday in a statement. "Don't mess with the health and well-being of New Yorkers — not on my watch."
  • Anthem representatives did not immediately respond to requests for comment.

The initial coverage decision was very unusual for a major health insurer, said Marianne Udow-Phillips, who teaches insurance classes at the University of Michigan School of Public Health and formerly made coverage decisions at Blue Cross Blue Shield of Michigan.

  • "When patients become financially responsible because a health plan cuts how much they pay providers, that's what breeds all this anger," Udow-Phillips tells Axios.
  • "This is a colorful and terrible example of administrative excess in the insurance industry, but boy, I tell you, it's just the tip of the iceberg," Gordon Morewood, an anesthesiologist and vice chair of ASA's Committee on Economics, tells Axios' Maya Goldman.

On social media, critics drew a direct line from controversial coverage decisions to the death of Thompson.

  • "When you shoot one man in the street it's murder. When you kill thousands of people in hospitals by taking away their ability to get treatment you're an entrepreneur," an X user wrote.
  • "Saw mainstream news coverage about the killing of the CEO of United Healthcare on TikTok and I think political and industry leaders might want to read the comments and think hard about them," activist Tobita Chow wrote on X.

The bottom line: The fact that public scorn toward insurance executives could turn into violence is a startling reflection of how social media outrage can translate into real-world consequences.

  • "I would never have thought at that time that I needed security," Udow-Phillips said of her time at BlueCross. "Does this give permission to other people? It's terrifying."

Editor's note: This report was updated with the statement from New York Gov. Kathy Hochul.

This article was originally published on AXIOS.