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Life Health > Health Insurance > Health Insurance

Consumer rep: The health rate windows are blurry

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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.

HHS posts the explanations on the Web at

In theory, the new PPACA rate review rules should be increasing consumers’ ability to analyze and comment on rate filings.

In practice, Ditré said, states’ implementation of the rules varies widely.

At least 44 states offer rate filing information on their own websites, or at least provide links to the site, but only 25 provide links to the underlying increase applications, only 23 provide filing summaries, and just 13 provide a narrative description of the filings, Ditré said, citing statistics published by the Henry J. Kaiser Family Foundation.

About half of the states that provide links to the actual filings provide no summaries or narrative descriptions of the filings, and that makes the filings difficult for consumers to locate and understand, Ditré said.

In some cases, he said, users must look through many filings to find filings of interest, because states do not allow users to sort the filings.

Simply letting consumers sign up to get e-mail notices when their health insurers ask for rate increases would be one way to improve consumers’ access to rate increase request information, Ditré said. 

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