The rate review provisions of the Affordable Care Act enhance transparency in the health insurance market and hold insurance companies accountable for rate increases. Rate changes are now public information, and issuers must provide data on requested increases of any size. While the average premium increased more in 2013 than in prior years, it was still less than typical growth prior to the Affordable Care Act. Consumers nevertheless benefited from an estimated reduction in premiums of nearly $1.0 billion ($290 million in the individual market and $703 million in the small group market). When added to the $250 million in MLR rebates that consumers received for CY 2013, the Affordable Care Act’s rate review and MLR provisions have, together, accounted for approximately $1.2 billion in premium reductions and rebates for consumers. In 2012 the total combined effect of these two provisions was $1.6 billion. For 2012 and 2013 the total combined effect of these two provisions was $2.8 billion.
For rate filings for plan years 2014 and later, issuers must submit data for all of the plans in their risk pools in a single rate filing to both their state and CMS.13 This data will substantially improve the ability to review rate impacts on the market as a whole, compare rates across issuers, and monitor changes over time. Using both historic and new filing and review methods, HHS will continue to monitor the long-term trend of requested and implemented rate increases in the health insurance market.
13 An issuer must submit data to HHS if the issuer has a rate increase of any size for any plan; if the issuer has a Qualified Health Plan in its single risk pool; or if the state Department of Insurance requires the issuer to submit the federal template when submitting rate filings. Although a tiny fraction of issuers may not meet any of these requirements, the vast majority of issuers will meet one or more of these requirements and therefore be required to submit data to HHS.