State Sen. Natasha Marcus, a 55-year-old attorney from Mecklenburg County, has represented District 41 since 2019. She opted not to seek reelection after her district was redrawn, choosing instead to challenge two-term incumbent Mike Causey in the insurance commissioner race. A graduate of Duke University School of Law, Marcus lives in Davidson with her husband.
The job
The North Carolina Commissioner of Insurance oversees the regulation of the state’s insurance industry. In addition to ensuring that insurance companies comply with laws and regulations, the commissioner is tasked with investigating consumer complaints and allegations of fraud. The annual salary for the office is $146,421.
Our Q&A with Marcus
How would you work to bring down health insurance rates for North Carolinians?
The insurance commissioner doesn’t have much direct impact on the costs that people have to pay in our state because health care pricing is a complicated web. It’s complicated on purpose, it seems to me, and there is not a flat rate that a commissioner sets that will apply to all policyholders.
That said, there are some really glaring reasons costs are so high. As a state senator, I’ve worked to support reforms on pharmacy benefit managers — they drive up the costs of prescription medications, in short — and was happy to support a bill in the Senate that would have put some guardrails on that and would have allowed us to begin to consider the the kinds of changes that other states have adopted. I’m very interested in having our state move forward with protections such as that for people who need medications.
There are also health care monopolies in our state that really drive up the cost of care for patients, and that’s an issue I’d like to look at. There is regulatory authority that I believe the commissioner should be doing a better job using to make sure that we have more companies offering policies here because competition brings down prices.
What’s the right level of regulation for an entity as large as Blue Cross and Blue Shield of North Carolina?
The right amount of regulation is right in the middle. This is a regulated market, and insurance is something people are required to have. It is not just a “some people can afford it and others can’t” sort of market. It needs to be affordable, fair and comprehensive — and it is the job of the insurance commissioner to make sure that it is. You’ve got to find the right price where there will be a vibrant marketplace of insurance options for people that is also affordable.
One important thing is to not have a conflict of interest. The current commissioner takes money from the various insurance companies that he’s supposed to be regulating, even though he is elected by the people of the State of North Carolina to represent us and keep the costs of insurance as low as possible. That’s why I’m not taking money from insurance companies and don’t want their PAC money. I don’t want them to have any sense that I owe them something when I’m elected. I want to work for the people of North Carolina and make sure that we’re doing right by the people of North Carolina.
Do you feel that there needs to be more insurance competition in North Carolina?
Absolutely. More competition brings down the prices and gives consumers what they want, which is options. They want to be able to shop around and not to be told, “There’s only one company that offers you any policy at all.” Greater competition should be a top goal of the insurance commissioner. He should be out there aggressively recruiting more companies to write policies in North Carolina instead of being passive, skipping national conferences and not working with our state on efforts to recruit more businesses to North Carolina.
What would you do to crack down on insurance fraud committed by health care providers?
There’s fraud on both sides, but we hear a lot from the current commissioner about cases of fraud involving the general public. Let me say up front: fraud is fraud. I don’t support it. I don’t want to look the other way, and I won’t when I’m commissioner of insurance. We have a whole department that is focused on fraud because it does raise the prices.
But it seems to me that there is some more systemic, larger fraud that happens, and those are the bigger picture problems. Sometimes, the people that get caught up in fraud investigations are the people who committed fraud, yes, but it’s what I’d call small potatoes stuff. It’s $60 here or there. I’m just not sure those are the kinds of cases that deserve top-level resources at the Department of Insurance.
We shouldn’t let any fraud go unpunished or un-investigated, but we want to look at patterns of denials of claims. Are insurance companies paying their claims fairly? Or is there a troublesome pattern of discrimination or refusal to cover certain things? That’s the kind of stuff that matters to me. It’s a problem if someone has been paying their policy all along and now they’re in the hospital battling something terrible, and the first thing the insurance company does is try to get out of paying anything by denying the claim and hoping the patient doesn’t have the resources or wherewithal to fight back.
What would you do to crack down on false advertising in the insurance industry?
Insurance agents have told me they’re very concerned that seniors who hold policies through their offices are getting phone calls from out-of-state people who talk them into signing up for a plan that is not right for them. They’re violating North Carolina law in doing that. You’re not allowed to cold call seniors and try to sell them medical care. But there’s very little crackdown, and that worries me because I think our seniors deserve to be protected and to have health care in their later years.
What else should voters know?
I’m running for this office because I believe that the people of North Carolina deserve an advocate in their corner. Somebody that’s going to fight for them and doesn’t have a conflict of interest and is more concerned about ensuring that insurance companies make higher and higher profits. I think that puts me in stark contrast to Commissioner Mike Causey. He used to be a lobbyist for the insurance company. Now he takes campaign money from insurance companies. That is not what this job is.
North Carolina is one of only 11 states that allow its people to vote for their commissioner of insurance. In all the other states, it’s an appointed position. That, to me, underscores the importance of making sure voters understand how much power we place in this one single person who we have an opportunity to elect only once every four years — and how much impact the person in this position has on your wallet. It is almost a direct line, especially on homeowners insurance and auto insurance where he literally sets the maximum rate that insurance companies can provide.
I look forward to being an advocate in the corner of the people of North Carolina, always putting their needs first and ensuring that we have a vibrant marketplace of insurance options with affordable, quality coverage for people so they can rest at ease, knowing that they’ve got an advocate working on their behalf.