Because of the burden that steep health insurance increases would put on the agency's limited budget, the board of directors decided it was time to switch insurers, which would save the agency about $8,000 a year. It has been with its current insurer since 1995.
"My concern, though, is that anytime you go with a different company, you worry that it's going to be a bad choice and that there may be a substantial increase next year," she said.
Children's Homes can afford employee health coverage right now, but with costs continually rising, there are no guarantees for the future.
"It's never an option to get rid of our coverage, unless it gets so expensive that it means we can't carry out our day-to-day responsibilities," she said.
"I would worry about adopting policy advocating improving the delivery of health care at a higher quality and a lower cost," Wilensky said.
"Premiums are increasing because medical costs are soaring," said Zirkelbach.
The AMA agrees that the health care system is flawed and services need to be more efficient and cost-effective, but that doesn't negate the need for a closer look at practices like purging.
"It doesn't change the fact that we believe it is not a fair practice," said Stack.
But it's one that some say could continue, even after the the Health Care Reform Act takes full effect in 2014. Although the legislation prohibits insurance companies from charging higher premiums because of one's sex, health status, family history or occupation, that provision may not offer enough protection.
"Because there are no real price controls on premiums, insurers will be free to continue to practice," said Potter.
That could lead to more and more small businesses dropping their insurance plans, which would leave many more individuals without coverage.
That's something the AMA, the insurance companies, lawmakers and advocacy groups are fighting against.
"You live sicker and die younger," said Stack.