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Iowa Officials Expound on Health Cost Study Effort

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Hawkeye State officials say they need help explaining to lawmakers whether health insurance rates are going up for reasons other than big executive compensation packages and office facility expansion.

The Iowa Insurance Division announced in June that it is looking for a vendor who can explain just why Iowa health care and health insurance cost so much. The division asked for help with deciding what sort of information ought to be collected, how the information ought to be analyzed, and what the cost of the data collection and analysis process might.

Division officials now have posted a collection of answers to vendors’ questions about the Iowa health cost study request for information (RFI).

“Generally speaking, what the division is hoping to learn from this request for information process is how to provide as much information to the legislature as possible given what is currently obtainable information, and to advise them of the things that are not currently being tracked,” officials say.

In some cases, the Iowa division might be able to get any additional needed information by requiring insurers to track the information, officials say.

The division also needs help with defining terms, and with expressing information in terms that members of the Iowa legislature and other laypeople who ask, “Why are health insurance costs so high?” can understand, officials say.

“Absent actuarial expertise in their ranks, they appear to believe linkage exists between executive compensation and office facility expansion and rate increases, rather than the medical cost increases, demographics, and frequency and severity data,” officials say.

Vendors have asked the Iowa division about the insurer and health maintenance organization contact information the division has.

The division has a database of small group plan insurers that contains contact names, telephone numbers and e-mail addresses, officials report.

“The division has a similar database for individual plan insurers, but it is only a Rolodex-style database containing company names, contact persons’ names, addresses, telephone numbers and e-mail addresses,” officials say.

Some states track the cost of providing state-mandated benefits. Iowa division officials note that Iowa does not track that information.

The Affordable Care Act – the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act – will require states to conduct annual reviews of “unreasonable increases in health insurance premiums,” and to have carriers justify any unreasonable premium increases in health insurance premiums.

“The threshold for unreasonable premium increases has not yet been established but is certainly an area where vendor expertise might be appropriate,” Iowa officials say.


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