In Washington state, the Office of the Insurance Commissioner didn’t have the authority to stop LifeWise from sending letters with selective information, a spokesperson told Scott. The regulatory office did issue a consumer alert in mid-September (also posted by TPM) urging consumers to “make sure you shop around,” though it didn’t mention LifeWise by name. This is Washington, by the way, a state where the insurance commissioner rejected some carriers from the state exchange because of “narrow network” issues before political pressure was brought to bear and the plans were allowed after all.

Kentucky regulators, on the other hand, slapped a $65,000 fine on Humana for sending letters containing “misleading” information. State insurance commissioner Sharon Clark told Scott that some customers were badgered through phone calls to make a decision; of the 6,500 people who got the letters, 2,200 responded before they had a chance to investigate exchange options, Clark said.

Regulators in Colorado received similar complaints, and forced Humana to issue an apology and a corrected letter that met state standards. And in Missouri, regulators are investigating similar complaints. What about other states? Sounds to me like a good tip for further investigation.

One thing missing from Scott’s story was a bit of Humana’s past. The company has a history of aggressive marketing tactics relating to Medicare HMOs and, later, Medicare drug benefits. It got into hot water with regulators and made amends, all the while amassing huge market share that transformed the company into one of the nation’s largest health insurers. A bit of this backstory would add more context to the current events.

That aside, Scott’s article shows it’s possible to break through the insurance industry’s formidable wall of silence. Even if insurers continue to circle the wagons, there’s plenty on the public record that provides an entry point to understanding what the game is all about—competition and market share.

Related content:

A failure to ‘ask the questions’

Untangling Obamacare: Shopping the insurance exchanges

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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.