Consumer rep: The health rate windows are blurry

Regulators in most states could do more to open up their health insurance rate review processes, a consumer group representative told a National Association of Insurance Commissioners panel.

Today, “consumers and their representatives find it hard to access and understand [the] information needed to participate meaningfully in rate reviews,” the consumer group rep, Joseph Ditré, said at a recent meeting of the NAIC’s Consumer Liaison Committee.

One way to help consumers participate in the rate review process would be to train them to understand the process, and another way would be to hire an experienced consumer advocacy group to provide the training, Ditré said, according to a written version of his presentation posted on the Consumer Liaison Committee’s section of the NAIC website.

Ditré appeared on behalf of Consumers for Affordable Health Care (CAHC), a group that says it represents the health care consumers in Maine.

For years, some states have given insurance commissioners the authority to deny or change what they believe to be excessive rate increase requests. Some states also have posted rate increase request applications on the Web and given members of the public a chance to comment on the requests.

The drafters of Patient Protection and Affordable Care Act of 2010 (PPACA) did not give state insurance commissioners or federal regulators the authority to reject or change proposed rate increases, but they did give regulators the authority to require that explanations of all requests for increases over a certain level to be posted on the Web.

The U.S. Department of Health and Human Services (HHS) now requires that insurers post explanations of all increase requests over 10 percent.