Rate Review

Coverage_Blog

compliance

Many experts agree that focusing solely on health insurance premiums while ignoring underlying medical cost drivers will not make health care coverage more affordable. The public policy discussion needs to be enlarged to focus on the soaring cost of medical care that threatens our economic competitiveness, public safety net and the affordability of coverage.

Premium review must adequately factor in all of the components that determine premium rates, including geographic variation, the cost of new benefit mandates and the impact of younger and healthier people dropping coverage. Capping premium increases without looking at the underlying components is similar to capping the prices auto makers can charge consumers, while allowing the steel, rubber and technology manufacturers to charge the auto makers whatever they want.

States are best suited to review premiums because they have the experience, infrastructures and local market knowledge necessary to ensure that consumers are protected and health plans are solvent. The federal government has neither the capacity nor the expertise needed to make these assessments.

Any review of premiums should be based on objective actuarial standards to avoid a politicization of the rate review process that will cause disruption for consumers and financial instability throughout the system.

Latest Resources

Health Plans’ Estimated Costs of Compliance with Expanded Federal Rate Review and with Data Collection for Risk Adjustment and Reinsurance - [PDF]

In December 2012, AHIP conducted two surveys of member health plans regarding new regulatory guidelines released by the Department of Health & Human Services (HHS) for implementation of the Affordable Care Act. Plans were asked to submit responses to surveys concerning: 1) the proposed expansion of the federal rate review and data submission process, and 2) the proposed risk adjustment and reinsurance data collection process.

Research | Center for Policy and Research | 12/21/2012

Rate Review: What You Need to Know - [PDF]

 

Fact Sheets/Issue Briefs/Talking Points | Strategic Communications | 07/13/2012

AHIP Statement on Rate Review

America’s Health Insurance Plans’ (AHIP) President and CEO Karen Ignagni today released the following statement on the rate review rule released by the Department of Health and Human Services.

Press Releases | Strategic Communications | 05/19/2011

AHIP Letter to HHS on Rate Review Regulations - [PDF]

AHIP’s letter to HHS on the proposed rate review regulations states that rate review should continue to be done at the state level and should take into account all of the factors driving premium increases, including soaring prices for medical services, new benefit mandates, and changes in the risk pool.

AHIP Comment Letters | 02/22/2011

AHIP Statement on Rate Review

America’s Health Insurance Plans’ (AHIP) President and CEO Karen Ignagni today released the following statement on the proposed rate review rule released by the Department of Health and Human Services.

Press Releases | Strategic Communications | 12/21/2010

Setting the Baseline for the Individual Market - [PDF]

This Hay Group presentation provides an overview of how health insurance premiums are calculated and the factors that contribute to premium increases.

Reports/Research/White Papers | 07/20/2010

AHIP Letter to HHS on Health Insurance Rate Review - [PDF]

AHIP’s letter to HHS on the proposed rate review regulations states that rate review should continue to be done at the state level and should take into account all of the factors driving premium increases, including soaring prices for medical services, new benefit mandates, and changes in the risk pool.

AHIP Comment Letters | 05/14/2010