States get federal help to keep health insurance affordable

By Joseph Picard: Subscribe to Joseph's

August 18, 2010 12:09 PM EDT

"Insurance commissioners across the country need more resources to crack down on insurance company abuses," said Sen. Max Baucus, D-MT, and chair of the Senate Finance Committee.  "These grants will help protect consumers and hold insurance companies accountable for unjustified premium increases."

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The administration had planned on giving states full rate review authority in the healthcare reform legislation passed earlier this year, but such a provision was excluded from the final version of the bill.

Baucus and other lawmakers managed to include in the reforms more than $250 million in grants to allow states to closely review proposed increases in insurance rates.  The first round of grants was announced Monday by Secretary of Health and Human Services Kathleen Sebelius, sending $46 million to 45 stats and the District of Columbia.

Five states -- Alaska, Georgia, Iowa, Minnesota, and Wyoming -- did not apply for the funding, but still have the option of doing so.

Sibelius explained how the grants are a part of the administration's plan, under the reform legislation, to make health insurance more affordable.

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"The Affordable Care Act puts in place critical market reforms to improve quality and reduce the cost of health care for employers and individuals," she said in the HHS release. "Increased competition, lower insurance overhead, and better risk pooling in health insurance Exchanges in 2014 are expected to reduce premiums in the individual market by anywhere from 14 to 20 percent, according to the Congressional Budget Office."

In the meanwhile, HHS will work with the states  "to ensure consumers are receiving value for their premium dollars and to avoid the kind of double digit premium increases seen recently,' Sibelius said.

States will be using the money in various ways to protect consumers and persuade health insurers more to be reasonable in seeking premium increases.

According to HHS, some states will pursue additional legislative authority for stricter review standards; other states will expand existing review procedures; nearly all the states involved will increase the transparency of the health insurance premium review process and provide easy-to-understand information to the public about changes to their premiums; and all state grantees will develop and upgrade existing technology to streamline data sharing and put information in the hands of consumers more quickly.

"Any increase for Connecticut consumers must be fair and justified. We want to make absolutely certain that our families and businesses have clear and accurate details on the cost of their insurance," Connecticut Governor M. Jodi Rell said. "These funds will help us ensure that insurance companies' requests for premium increases are necessary and that consumers have access to all the details of that request and how an increase will affect them."

"This grant will help us accomplish our mission by providing increased transparency to Connecticut consumers, additional tools and resources to increase the rigor of our current rate review process, and to allow us to uphold the federal health care review laws," said Thomas R. Sullivan, Connecticut's commissioner of Insurance.

Earlier this year, when the healthcare reform proposal passed without a provision for state review authority, Sibelius urged states to adopt their own laws authorizing such power. She also called on certain insurers to justify large premium increases.

Sibelius said that the light the federal government and several states shone on the practices of some insurers caused them to back off inappropriate premium hikes.

Among the insurance companies Sibelius alluded to is Wellpoint, which proposed premium increases of as high as 39 percent to its California customers in January. Sibelius called upon Wellpoint to reconsider, as did California officials and Sen. Baucus and his colleague on the Finance Committee, Sen. Chuck Grassley, R-IA.

Wellpoint reduced its proposed increases from 39 percent to 14 percent.

"Health insurance companies should be spending money providing quality health care, but instead we find they are using these dollars to rack up huge profits," Baucus said. "Health care reform ends these abuses by requiring insurers to spend more of their revenues on actual health benefits and by shining a spotlight on unjustified premium increases." 

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