• Understand that in this system of commercial, for-profit insurance, the carriers will have the last word, despite all the huffing and puffing by politicos and advocacy groups like HCAN, which has called for a nationwide review of WellPoint’s rates. If they can’t get the increases they expect and say they need, they will compensate in other ways—by designing policies that cover very little, or shifting more cost to policyholders through sky-high deductibles. In Maine, some already reach $15,000. Those actions could hurt policyholders even more. Ultimately, they can stop selling policies in states with unfriendly rate regulation.

In his weekly roundup for Oppenheimer & Co., Carl McDonald speculated: “If WellPoint isn’t granted something close to the rate increase they are requesting, we wouldn’t be surprised to see the company exit the individual market in the state. Doing so would send a message to state regulators across the country that they can only go so far in limiting plan rate increases before plans are no longer willing to remain in the market.”

So goes Maine.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.