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Rate Review: Spotlight on State Efforts to Make Health Insurance More Affordable

The Patient Protection and Affordable Care Act creates a new federal role to examine “unreasonable increases” in the premiums charged for certain individual and small group health plans. Under the health reform law, the U.S. Department of Health and Human Services (HHS) will work with state insurance departments to conduct an annual review of unreasonable rate increases, and insurers must provide justification for such increases to HHS and to the public via their websites. The new law also allots $250 million for state insurance departments to enhance their process for reviewing proposed rate increases.

This study examines the existing laws and regulations in all 50 states that currently govern the review process for health insurance rates. It finds dramatic variations across states, with some states having with no authority at all and others with robust authority to review and approve or disapprove rates before they are implemented. Researchers also interviewed insurance regulators in 10 states (Alaska, Connecticut, Colorado, Idaho, Louisiana, Maine, Ohio, Pennsylvania, South Carolina, and Wisconsin) to see how different levels of rate regulation work in practice.

The study was conducted by researchers at the Georgetown University Health Policy Institute and the Kaiser Family Foundation.

Report (.pdf)

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