Between 2010 and 2012, 47 states, including the District of Columbia, received Rate Review Grants. States are using Rate Review Grant funds to implement extensive enhancements to their rate review programs and increase publicly-available data. One means of enhancing their programs was to institute rate review authority. Between 2010 and 2012, the number of states with prior rate review authority for their small group health insurance market products increased from 29 to 36 states.10 States with prior rate review authority for their individual health insurance market products increased from 34 to 37 states.11 While only a limited number of states made rate filings public before the Affordable Care Act (e.g., Arkansas, Florida, North Carolina, Oregon, Pennsylvania, and Wisconsin), 35 states now have rate filings or summaries of rate increases publicly available on their state insurance websites. Other examples of state activities include:
- Arkansas: The Arkansas Insurance Department created the Insurance Rate Analysis and Tracking Engine (iRATE) to automate and streamline the rate review process. The iRATE system is a customizable application that permits state officials to quickly retrieve and analyze the filing data required by their states’ rules and regulations. Upon completion in 2013, Arkansas made iRATE available to every state and territory, free of charge.
- Illinois: In 2012, the Illinois Department of Insurance used Rate Review Grant funds to develop a new rate review website with an interactive web tool displaying individual and group rate filings from 2005 to 2012.
- Maryland: Prior to July 1, 2012, the Maryland Insurance Administration only posted rate filings that proposed increases of 10 percent or more. Starting on July 1, 2012, the Maryland Insurance Administration began to publish all proposed rate filings in the individual and small group market.
- Nebraska: Nebraska developed and released a new rate review website, which permits consumers to comment online on rate filings and to learn more about the rate review process. By the end of 2012, the new website had almost 90,000 hits.
- New Jersey: In New Jersey, Rate Review Grant funds enhanced rate complaints investigations, which helped the state to institute a new tracking and consumer response system. One investigation revealed that policyholders had been overcharged due to an unintended administrative error.
- Oregon: Oregon’s Department of Consumer and Business Services (DCBS) used Rate Review Grant funds to hold live-stream rate review hearings on almost all small group and individual health benefit plan rate filings. For those who attended the hearing via live-stream, DCBS permitted phone-in testimony. After each hearing, DCBS posted the video file on its website, enabling the public to watch hearings at their convenience. During fiscal year 2012, rate review performed by the Oregon Insurance Division resulted in decreases to approximately three-quarters of the proposed rate hikes. Also, two new actuaries are helping the state to provide greater scrutiny of proposed rate hikes. In addition, Oregon has contracted with a consumer advocacy organization to represent consumers in the rate review process, participate in hearings, and develop long-term strategies to increase consumer input.
- Pennsylvania: Pennsylvania enacted a statute granting the Department of Insurance the authority to regulate commercial small group health premiums, effective March 21, 2012. Not only did this new authority permit greater scrutiny of proposed rate increases, it has also allowed the Department of Insurance to identify and halt improper rating practices by insurance companies.
- Rhode Island: Rhode Island is using its Rate Review Grant funds to expand its rate review oversight to address the underlying factors driving rate increases. By issuing and implementing “Affordability Standards” as part of its rate review process, Rhode Island is engaging health plans in delivery system transformation.