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PPACA: HHS Spends $46 Million on Premium Reviews

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The U.S. Department of Health and Human Services (HHS) is sending $46 million to 45 states and the District of Columbia to improve oversight of health care insurance premium increases.

States also can use the grants, which will help regulators implement the Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act (PPACA), to act against unreasonable rate hikes, according to HHS officials.

“For too long, insurance companies in many states have increased health insurance premiums with little oversight, transparency or public accountability,” HHS officials say in announcing the grants. “Health insurance premiums have doubled on average during the last 10 years, much faster than wages and inflation, putting health coverage out of reach for millions of Americans and business owners.”

Today, regulators in 26 states and the District of Columbia have the authority to reject proposed increases that they deem unwarranted. Regulators in some states have no such authority, and, even in jurisdictions in which regulators can throw out unreasonable increases, regulators lack the means to apply that authority effectively, officials say.

In 2014, a new health insurance exchange coverage distribution system will promote health insurance risk pooling.

Until then, HHS will work with states “to ensure consumers are receiving value for their premium dollars and to avoid the kind of double-digit premium increases seen recently,” HHS Secretary Kathleen Sebelius says.

The Affordable Care Act will provide states with $250 million in health insurance premium review grants over 5 years.

HHS officials say 15 states and the District of Columbia have proposed expanding their authority to review premium increases.

Many states have said they will use the grants to expand their current health insurance review processes and to require insurers to provide more information to justify rate increases. Much of this information will be made public, officials say.

States also can use the grants to improve technology to simplify data collection and share information about premium increases with consumers, officials say.


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