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Montana to receive $1 million to help crack down on unreasonable health insurance premium hikes

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Affordable Care Act Grants will make health Insurance markets more consumer-friendly and transparent

HHS -- Health and Human Services Secretary Kathleen Sebelius announced Monday the award of $l million to Montana to help crack down on health insurance premium increases. Montana will use this Affordable Care Act funding to help improve the oversight of proposed health insurance premium increases, take action against insurers seeking unreasonable rate hikes, and ensure Montanans receive value for their premium dollars.

"The Affordable Care Act puts in place critical market reforms to improve quality and reduce the cost of health care for employers and individuals. 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 14-20 percent according to the Congressional Budget Office," said HHS Secretary Kathleen Sebelius. "Between now and then, we will continue to work with states to ensure consumers are receiving value for their premium dollars and to avoid the kind of double digit premium increases seen recently. The state proposals approved demonstrate the need and desire for new resources and tools to help them protect against unjustifiable premium increases."

The Affordable Care Act provides states with $250 million in Health Insurance Premium Review Grants over five years to help create a more level playing field by improving how states review proposed health insurance premium increases and holding insurance companies accountable for unjustified premium increases. Applications for the first round of Health Insurance Premium Review Grants were made available on June 7.

The grants build on the Obama Administration's

work with states to implement the Affordable Care Act. Earlier this year, Secretary Sebelius called on certain insurance companies to justify large premium increases and encouraged state and local officials to obtain stronger health insurance premium review authorities under state laws. This increased scrutiny by the Administration and by several states has led to the withdrawal or reduction of several proposed health insurance premium increases that in some cases turned out to be based on faulty assumptions and data.

This grant will be used for the purposes detailed in the approved application. The following is a general summary of how Montana intends to use its funding:

Pursue Additional Legislative Authority: Currently, the Commissioner of Securities and Insurance (CSI) has limited authority to review health insurance premium increases. The Commissioner intends to draft a bill to present to the legislature in 2010 that will grant the CSI review and approval authority over major medical health insurance rates.

Expand the Scope of the Review Process: Currently, individual market carriers are not required to file health insurance premiums. Small group market carriers must file actuarial certification that rating rules are in compliance with Montana law. The State will seek to obtain authority to require all major medical health insurance rates to be filed, reviewed and approved in all markets.

Improve the Review Process: Montana does not have any legal authority requiring major medical rates to be filed with or reviewed by CSI. The proposed rate filing law will provide review and approval authority and enable CSI to enforce all rating protections that exist in the Affordable Care Act. If Montana is not granted additional authority by the legislature, grant funds will be used to improve enforcement of its existing rating laws and new federal laws; expand targeted market, conduct examinations and complete more in-depth analysis of small group actuarial certifications; develop rating manuals; and enhance consumer protections.

Increase Transparency and Accessibility: The proposed legislation will provide for a consumer comment period and permit consumers to request public hearings. CSI will also provide detailed health insurance premium information, such as health insurance premium increase requests and rating trends, in a consumer-friendly format on its website.

Develop and Upgrade Technology: Montana will collect additional filing data and establish a data center to compile and pubhsh fee schedule information.

"States will use these grant dollars in the way that makes the most sense for their insurance consumers," said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight. "As we continue to implement the new health insurance reform law, we will continue to work with states to ensure they have the tools they need to ensure the stability of the marketplace, keep costs low and provide consumers with increased transparency, choice and quality they need to make the best healdi care decisions for their businesses and families."

The Health Insurance Premium Review Grants are one element of a broad effort under the Affordable Care Act to reduce the unreasonable premium increases proposed by some insurers today. Additional resources from this $250 million program will be available in subsequent years to further strengthen state health insurance premium review procedures.

The Affordable Care Act includes a wide variety of provisions designed to promote a high-quality, high-value, healm care system for all Americans and to make the health insurance market more consumer-friendly and transparent. Some of the provisions that take effect by the end of next year, or are already in effect, include prohibitions on pre-existing condition exclusions for children; prohibition on lifetime dollar limits in all health plans; extended access to insurance for many young adults; and an unprecedented level of transparency about health insurance through www.HealthCare.gov.



Copyright 2010 Blackfoot Valley Dispatch, Lincoln, Montana. All Rights Reserved. This content, including derivations, may not be stored or distributed in any manner, disseminated, published, broadcast, rewritten or reproduced without express, written consent from SmallTownPapers, Inc.

© 2011 Blackfoot Valley Dispatch Lincoln, Montana. All Rights Reserved. This content, including derivations, may not be stored or distributed in any manner, disseminated, published, broadcast, rewritten or reproduced without express, written consent from DAS.

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