In 2013, lower health insurance rates saved consumers a total of $1 billion. States that enhanced their rate review programs will receive $25 million in rate review grant awards.
In 2013, lower health insurance rates saved consumers a total of $1 billion, according to a new report released by HHS Secretary Sylvia M. Burwell. She also announced 21 states would receive $25 million in rate review grant awards.
Through the Affordable Care Act (ACA)’s “rate review” provision and state efforts, consumers are already benefitting from lower-than-requested premium increases. Individuals saved $290 million in 2013 and small employers saved a total of $703 million. The ACA requires insurance companies publicly justify any rate increase of at least 10%.
“Before the Affordable Care Act, consumers regularly faced significant annual premium increases,” Burwell said in a statement. “In 2013 alone, we see that rate review programs saved consumers approximately $1 billion while providing them with the information they need to get the care they deserve.”
According to HHS’ report, implemented rate increases were smaller than what was originally requested in both the individual and small group markets. This is consistent with a trend in place since the rate review provision went into effect.
Rate review works in conjunction with the 80/20 rule, which requires insurers spend at least 80% of premium dollars on patient care and quality improvement activities. Insurers that spend an excessive amount on profits and “red tape” owe a refund to consumers, according to HHS. In 2012 and 2013, refunds from the 80/20 rule and lower than initially requested rates saved consumers more than $2.8 billion total.
States that enhance their rate review programs and bring greater transparency to the process are awarded Health Insurance Rate Review grants. This funding supports state efforts to review rate increases, educate consumers, help hold insurance companies accountable, and scrutinize medical pricing data.
The following 21 states are receiving awards: Arizona, Arkansas, California, Delaware, Hawaii, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, Oregon, Rhode Island, Utah, Vermont, Washington, and Wisconsin.
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
The Pivotal Role of Payers in Improving Health Equity, Maternal Health Care in the US
March 26th 2024A presentation at the Greater Philadelphia Business Coalition on Health's 2024 Women’s Health Summit discussed how payers, including employers and public entities, can strategically influence health care purchasing to prioritize maternal health and equity.
Read More
What We’re Reading: HHS' Funding Flat; Mifepristone Safety; Insulin Shortage
March 25th 2024Flat funding for HHS leaves critical health initiatives stagnant; Supreme Court weighs tightening regulations on abortion pill; manufacturing delay sparks access concerns for insulin medication.
Read More