Prescription for Change A new direction for healthcare...

Rate Review

To stop spiraling health insurance rates, we urge state officials to review rate increases for reasonableness, disclose an insurer’s rate calculations, and give consumers a voice in the review process. Policyholders have saved millions in states with a strong rate review process. Use this information to push for a better rate review process in your own state.

Consumers Union Documents

Press Releases

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Other Resources

  • 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.

Blog Posts

  • Consumers demand transparency, health insurance rates remain hidden

    We have to admit it. We can’t figure out what the folks in Washington, D.C., overseeing health insurance, are thinking. Instead of releasing the information about proposed insurance rates for next year – so consumer groups like ours have time to fight unfair rate hikes before they go into effect – the people over at Continue Reading

  • Trend setters: how much does the cost of health care increase each year?

    (This is the 4th in a series of blogs on health insurance rate review) As we explained in our earlier blog posts, health insurance companies are starting to submit to state and federal officials information on what health insurance plans they will offer and at what price. A major factor in how insurers decide what prices to charge is the projected medical Continue Reading

  • No more excuses! Distinguishing “need” from “desire” when insurers want to raise rates

    (This is the 3rd in series of blogs on health insurance rate review) As we explained in our earlier blog posts, health insurance companies are starting to submit to state and federal officials information on what health insurance policies they plan to offer and at what price. It’s a fact of life that costs are constantly increasing Continue Reading

  • Figuring out health insurance rate requests is getting simpler, and you can weigh in!

    (This is the 2nd in series of blogs on health insurance rate review) As we explained in our earlier blog post, this summer, health insurance companies must submit to state and federal officials the cost and coverage details of their insurance plans. In many states, consumers can weigh in on the process. Although Obamacare simplified the math Continue Reading

  • Insurance rates are being filed, consumers need to pay attention

    In every state this summer, customers, advocates, and politicians will hopefully stop speculating and find out what health insurance plans want to charge in 2015 – that is, if we can get the federal Health & Human Services department (HHS) to release the details of these rates. That’s why Consumers Union joined with over 60 other advocacy groups nationwide to Continue Reading

  • CA Department of Managed Care Saves Consumers Over $13.3 Million in Unjustified Premiums

    Consumers Union applauds CA DMHC’s efforts to protect consumers from unreasonable rate increases.  DMHC negotiated with Aetna and Anthem Blue Cross to lower their requested rate increases.  Anthem Blue Cross agreed to lower their requested increase in the individual market from 15% to 12.5% saving consumers $11.5 million. Consumers will reap a savings of $122 Continue Reading

  • Consumers Union Urges CA Department of Managed Care to Reject Aetna’s Proposed Rate Hike

    Consumers Union submitted comments today urging  the CA Department of Managed Care to reject Aetna’s requested  9.9% increase over last year in the small group market.  Aetna has been posting record profits and an average return on surplus of about 26% – more than twice as high as a reasonable value.   Aetna’s requested rate Continue Reading

  • Rate review proving effective at holding insurance companies accountable

    Yesterday the Department of Health and Human Services (HHS) added to the list of benefits we’re already seeing from the Affordable Care Act (ACA), better known as the new healthcare law, announcing that premium increases in nine states have been deemed “unreasonable” after a review by independent experts. The ACA’s rate review program posts all double-digit increases online, Continue Reading

  • Washington state regulator uses rate review to protect consumers

    Last week, Washington Insurance Commissioner Kreidler rejected Time Insurance Company’s request for a 37% rate increase and instead approved a 19% rate increase. The company had asked for the rate increase to be effective in January- but because of the time it took to thoroughly review the filing – consumers will be spared any increase Continue Reading

  • State misses an opportunity to further protect consumers from rising rates

    Last night, a pro-consumer bill we strongly supported died in the Washington State Senate as lawmakers missed an opportunity to improve protections for families and small businesses struggling with rising premiums. The bill (SSB 5247) would have required the Insurance Commissioner to consider nonprofit health insurance companies’ surplus when deciding whether premiums are reasonable for individuals Continue Reading

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News Articles

  • Millions expected to receive insurance rebates totaling $1.3 billion
    Source: Kaiser Health News (Thursday April 26, 2012)

    Millions of consumers and small businesses will receive an estimated $1.3 billion in rebates from their health plans this summer under a provision of the health care law that effectively limits what insurers can charge for administration and profits, a new study projects.

  • U.S. cites two health insurers over premium hikes
    Source: Reuters (Monday April 16, 2012)

    U.S. officials on Monday cited two health insurers for excessive premium increases, under consumer protection rules of President Barack Obama’s healthcare reform law.

  • HHS: Insurance rate hikes too high in 9 states
    Source: Medpage (Thursday March 22, 2012)

    Two health insurance companies covering enrollees in nine different states, including Nebraska, sought rate increases that were too high, according to the Department of Health and Human Services (HHS). “It’s time for these companies to immediately rescind these unreasonable rate hikes, issue refunds to consumers, or publicly explain their refusal to do so,” Sebelius said.

  • Senate bill could roll back consumers’ health insurance savings
    Source: ProPublica (Friday March 16, 2012)

    This summer, health insurance companies may have to pay more than a billion dollars back to their own customers as part of the 2010 health-care reform law. But now an insurer-supported Senate bill aims to roll back the rebate requirements.

  • HHS calls Trustmark’s rate increases in five states ‘unreasonable’
    Source: Kaiser Health News (Thursday January 12, 2012)

    Under the 2010 federal health law, states – or in some cases, the federal government – must review premium increases of 10 percent or more, and insurers must publicly justify those deemed unreasonable. Information is also posted on a federal government website.

  • Workers' health premiums rose 63% in seven years, study shows
    Source: San Francisco Chonicle (Wednesday November 23, 2011)

    U.S. workers’ health insurance premiums rose 63 percent from 2003 to 2010 as employers shifted more of the burden of rising medical costs to individuals and families, according to a Commonwealth Fund study.

  • Obama administration rejects Republican states' health law waiver requests
    Source: The Hill (Monday November 28, 2011)

    The Department of Health and Human Services determined that the health plans of Indiana and Louisiana can meet the new health law’s medical loss ratio and that consumers will get better value without an adjustment. The MLR provision requires insurers to spend at least 80 percent of premiums on medical care or offer rebates to their Continue Reading

  • Obama administration calls on health insurer to reduce rate hike
    Source: Los Angeles Times (Tuesday November 22, 2011)

    The Obama administration called on a health insurance company to reduce a planned rate increase in Pennsylvania, using a tool in the new healthcare law for the first time to pressure insurers to restrain rising premiums.

  • Insurer profits at issue in Anthem Health Plans of Maine suit
    Source: Washington Post (Saturday October 29, 2011)

    A lawsuit challenging Maine’s authority over health insurers’ profit margins is drawing national attention from state regulators worried about the impact on their power to hold down rate increases.

  • Cost of employer insurance plans surge in 2011
    Source: Kaiser Health News (Tuesday September 27, 2011)

    Employers’ spending on health coverage for workers spiked abruptly this year, with the average cost of a family plan rising by 9 percent, triple the growth seen in 2010. Family plan premiums hit $15,073 on average, while coverage for single employees grew 8 percent to $5,429, according to a survey released Tuesday by the Kaiser Family Foundation Continue Reading

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