A new direction for healthcare...
Our insurance premiums keep going up. Starting next year we were told that in order to keep my wife on our policy I would have to pay an additional $800 a month. I am retired and cannot afford $800 a month. WE NEED THE PUBLIC OPTION TO COMPETE WITH THESE CROOKS!
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
- Health Insurance Rates: Flexing Your Consumer Muscle
- Health Reform’s ‘Value for Your Dollar’ Rule: Early Impact in Florida (PDF)
A new rule that demands better value from health insurance companies is beginning to change business practices at some of Florida’s largest insurance companies and consumers will soon be due millions in rebates, according to preliminary data released in April.
- Summary of Rate Information on State Insurance Websites – December 2011
This chart summarizes the information about rate increases and rate review available on state insurance agency websites as of December 20, 2011.
- Summary of PPACA Rate Increases as of December 2011
This chart summarizes rate increases of 10 percent or more that were listed on the U.S. Department of Health and Human Services healthcare.gov website as of December 14, 2011.
- Health Insurance State Rate Review Toolkit
Why do insurers raise rates? Are they required to justify rate hikes, and if so, how?
- CU comment on HHS Rate Increase Disclosure and Review Reporting Requirements
CU comments to the U.S. Department of Health and Human Services (HHS)
- CU comment on HHS Rate Increase Disclosure and Review Reporting Requirements
Download Comments as PDF Introduction Consumers Union, the independent, nonprofit publisher of Consumer Reports, is pleased to provide the following comments to the U.S. Department of Health and Human Services (HHS). These comments address the proposed Rate Increase Disclosure and Review Reporting Requirements under Section 1003 of the Patient Protection and Affordable Care Act (ACA) Continue Reading
- 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.
- Federal Health Reform Improves Rate Oversight
Federal health reform (PPACA) gives states new tools to control rising insurance rates.
Press Releases
- CU applauds first ever federal rate review
This is the kind of scrutiny that is needed to ensure that rate hikes are fair and justified
- September 1: Health insurance rates get stricter scrutiny
Affordable Care Act requires closer review of rate hikes over 10% for individual and small group health plans
- CMS Identifies States With Inadequate Health Insurance Rate Review
The Centers for Medicare and Medicaid Services (CMS) issued a report today identifying ten states that currently lack sufficient authority to review health insurance rate hikes as required under the Affordable Care Act.
- HHS Issues New Rules To Help Rein In Health Insurance Rate Hikes
Rate hikes will be subject to stricter scrutiny and public disclosure.
- Washington governor signs insurance rate reform bill
New law makes health insurance rate filings more transparent
- Gov. Martinez signs good health insurance rate review bill
The new law will help make health insurance rate review more open, thorough, and fair for New Mexico
- Washington Senate OKs Bill to Make Health Insurance Rate Filings More Transparent
The bill would make health insurance rate filings public and give consumers access to critical information about their health insurance premiums.
- CU offers guide to health reform options & benefits
On first anniversary, the guide offers information about the law and how it affects you and your family
- Washington House Passes Bill to Make State Review of Health Insurance Rate Hikes More Transparent
Legislation approved by the House will provide consumers with more information about proposed health insurance rate hikes
- HHS Issues New Grants to Help States Protect Consumers From Health Insurance Rate Increases
Grants will help states make rate review more open, thorough & fair for consumers
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
- 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
- Holding health insurance companies accountable
Keeping your health insurance costs down is one of our top priorities. Which is why we’ve been working both publicly and behind the scenes to make sure insurance companies adhere to the new national health care law that says they can’t spend more than 20 percent of your premium on their overhead, marketing or CEO Continue Reading
- HHS continues to carefully consider state requests to waive new MLR rule
On Friday, it was announced that the Department of Health and Human Services rejected North Dakota’s request for a waiver to the new requirement that insurers spend at least 80% of premiums on medical care. The new requirement aims to increase a company’s medical loss ratio, or MLR, to the benefit of consumers who’ll see Continue Reading
- Governor’s SB11 veto leaves much work for consumers
Connecticut residents finally got a break from huge health insurance rate hikes in December when the state’s insurance department rejected a 20 percent requested increase from Anthem Blue Cross Blue Shield. Unfortunately, this one rejection was the exception, not the rule. Connecticut has a history of approving double-digit rate hike requests. A recent study from Continue Reading
- You spoke out, they listened
You’ve heard us talk about an important provision in the new health law that makes sure your insurance premiums are spent on actual health care, not just insurance company bureaucracy. This rule says insurers can’t spend more than 20 percent of your premium on administrative costs like advertising, salaries, and of course, profits. If insurers can’t Continue Reading
- More states need rate review like Oregon
Today, the Oregon insurance regulator rejected Regence’s request for a 22.1% rate increase and instead approved a 12.8% rate increase, saving consumers $12.5 million in the next year. The Department thought it was imperative to significantly lower the rate increase because a higher rate increase “would cause healthier members to drop their coverage, driving rates Continue Reading
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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