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Publications
Consumers Union produces original research, reports and documents on health insurance, health care, and health law. For more information about our original health research, contact Monique at blakmo@consumer.org.
Rate Review
- Health Insurance State Rate Review Toolkit
Why do insurers raise rates? Are they required to justify rate hikes, and if so, how?
- Health Insurance Premiums: Rate Review Model Bill
Health insurance rate increases deserve at least the level of public review given to auto and homeowners coverage.
- The Affordable Care Act: The First Year
Discover What the New Law Means for You and Your Family
- How Much Is Too Much: Have Nonprofit Blue Cross Blue Shield Plans Amassed Excessive Amounts of Surplus?
Have nonprofit Blue Cross Blue Shield plans amassed excessive amounts of surplus?
- Health Insurance Premium Review Grants: Detailed State by State Summary of Proposed Activities Source: U.S. Department of Health and Human Services (Wednesday December 1, 2010)
The U.S. Department of Health and Human Services has awarded funds to enhance states’ current processes for reviewing health insurance premium increases. A list of States’ current health insurance rate review practices and a summary of their intended use of these new resources is below.
- Spotlight on State Efforts to Make Health Insurance More Affordable Source: Kaiser Family Foundation (Wednesday December 1, 2010)
The ACA [new federal health law] does not alter states’ existing regulatory authority over health insurance rates. Such state authority varies dramatically, ranging from states with no authority at all to those that have robust authority to review and approve or disapprove rates before they are implemented. The authors of this issue brief conducted a survey of 50 state rate review statutes, and then did follow up interviews with insurance regulators in a subset of ten states to gain a deeper understanding of how rate regulation works in practice.
- The Price of Deregulation: How "File and Use" Has Undermined New York State's Ability to Protect Consumers From Excessive Health Insurance Premiums Source: New York State Department of Insurance (Tuesday June 9, 2009)
New York’s Insurance Department examines what happened after the state lost its authority to pre-approve health insurer’s premium rate increases and shows why prior approval is an important tool in controlling rates.
Better Consumer Information
- REPORT: Creating a Usable Measure of Actuarial Value (January 2012)
The health reform law uses the concept of “actuarial value” to standardize the financial protection offered by health plans starting in 2014. This report explores the policies needed to ensure that the new actuarial value requirements result in measures that are meaningful and usable by consumers.
- REPORT: What’s Behind the Door: Consumers’ Difficulties Selecting Health Plans (January 2012)
Consumer testing by Consumers Union confirms the widely held perception that people struggle to understand their health insurance policies. Read about our findings and our policy recommendations for strenghtening consumers’ understanding.
- REPORT: Addressing Barriers to Online Applications: Can Public Enrollment Stations Increase Access to Health Coverage? (November 2011)
This report looks at the use of public enrollment stations (sometimes known as “kiosks”) for helping people enroll in health coverage. Looking at pilot projects in a diverse set of states, including Alabama, California, Florida, Maryland, New Mexico and Washington, the paper summarizes the variety of ways agencies have facilitated public access to online enrollment. The paper identifies a number of important lessons learned from pilot projects, which will be important for those states moving forward to implement health care reform by 2014.
- Medicare: 6 Things You Need to Know Now
While the long-term future of the Medicare program is part of a national debate, you need to know about the important new services and changes to the program, available right now, that were part of the Affordable Care Act passed in 2010. That’s true whether you are currently on Medicare, about to become eligible, or Continue Reading
- REPORT: Early Consumer Testing of Actuarial Value Concepts (September 2011)
This study finds that consumers are very interested in knowing the value of their health plan choices; in other words, whether their options are a good value for their premium dollars. However, determining value is very difficult for consumers.
- BRIEF: Making Health Insurance Choices Understandable for Consumers – Meeting Synopsis (February 4, 2011)
Consumers Union held a public forum to discuss the importance of making health insurance choices understandable for consumers. The session highlighted specific sources of confusion and actionable solutions.
- BRIEF: Making Health Insurance Cost-Sharing Clear to Consumers: Challenges in Implementing Health Reform’s Insurance Disclosure Requirements (February 3, 2011)
This brief reports on findings from a Consumers Union study that examined consumers’ initial reactions to the new health insurance disclosure form called for by the Affordable Care Act.
- BRIEF: What will an “Actuarial Value” Standard Mean for Consumers?
“Actuarial value” is an estimate of the overall financial protection provided by a health plan. While actuarial value is a concept widely used by the insurance industry, it is not familiar to most consumers. This brief explains the concept of actuarial value and how the 2010 health reform law makes actuarial value to standardize the financial protection offered by health plans starting in 2014.
- BRIEF: Mini-med Health Plans: Don’t Call It Insurance
Mini-med health plans have garnered attention recently because their benefit levels don’t conform to new requirements being phased-in that all health plans provide coverage up to certain levels.
- New study finds confusion on plan cost-sharing options
The Affordable Care Act (ACA) calls for health insurers to disclose the benefits and costs of their health plan offerings in a standard way so families can compare options and make good choices. Consumers Union studied the early prototypes for this Summary of Coverage.
- REPORT: Building Mississippi's health insurance exchange Source: Center for Mississippi Health Policy (Sunday January 15, 2012)
Mississippi is moving forward to establish a state-based Health Insurance Exchange by the HHS deadline of January 1, 2014. The Mississippi Insurance Department has applied for and received federal grants to fund the development of the state’s Exchange… Approximately 275,000 Mississippians are anticipated to enroll in coverage through an Exchange once the ACA is fully implemented in 2014. Out of those expected to utilize Mississippi’s Exchange, approximately 229,000 should be eligible for premium subsidies, which will be administered by the federal government in the form of tax credits.
- Timeline of Health Reform Implementation
The Kaiser Family Foundation provides this timeline that explains provisions of the Affordable Care Act and when they go into effect.
Better Insurance Value
- BRIEF: Mini-med Health Plans: Don’t Call It Insurance
Mini-med health plans have garnered attention recently because their benefit levels don’t conform to new requirements being phased-in that all health plans provide coverage up to certain levels.
- New Health Reform Benefits Going Into Effect On January 1
As the new year begins, insurance companies will have to abide by new requirements on how premium dollars are spent, Medicare enrollees will get free preventive care and access to drug discounts, community health centers will receive more funding, and all hospitals will begin reporting certain patient infection rates.
- The Affordable Care Act: The First Year
Discover What the New Law Means for You and Your Family
- How Much Is Too Much: Have Nonprofit Blue Cross Blue Shield Plans Amassed Excessive Amounts of Surplus?
Have nonprofit Blue Cross Blue Shield plans amassed excessive amounts of surplus?
- A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan
Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for by health plans.
Read the Guide
The Affordable Care Act
Discover What You and Your Family Need to Know