Oregon is Cracking Down on Unreasonable Health Insurance Premium Hikes
For too long, insurance companies in many States have increased health insurance premiums with little oversight, transparency, or public accountability. Some States have both the authority and the capacity to review insurers’ proposed health insurance premium increases. Just 26 States and the District of Columbia have the authority to reject a proposed increase that is excessive, lacks justification or exceeds certain standards. Many do not and some who have the authority lack the right tools to exercise that authority to reject excessive premium increases. This lack of authority and resources for States has unfortunately contributed to unjustified premium increases. Health insurance premiums have doubled on average over the last 10 years, much faster than wages and inflation, putting coverage out of reach for millions of Americans and business owners.
The Affordable Care Act provides States with $250 million in Health Insurance Premium Review Grants over five years to help states like Oregon help transform the way they review proposed health insurance premium increases, take action against insurers seeking unreasonable rate hikes, and ensure consumers receive value for their premium dollars.
On August 16, the Department of Health and Human Services announced the award of $46 million in the first round of these grants, including $1 million for Oregon. The following is a general summary of how Oregon intends to use its funding:
- Expand the Scope of the Review Process: Oregon intends to expand review to include large group unreasonable health insurance premium increases.
- Improve the Review Process: Currently, Oregon reviews all individual and small group health insurance premiums to determine whether increases are justified and in compliance with the community rating law. Grant funds will be used to develop and implement a large group market health insurance premium review process.
- Increase Transparency and Accessibility: Oregon has a robust consumer transparency program including posting of information, public comment, and consumer email notification. Grant funds will be used to move stakeholder engagement to the next level by developing administrative rules and publicly disclosing more meaningfully information. In addition, Oregon will fund a consumer advocacy organization to collect comments on health insurance premium filings.
- Develop and Upgrade Technology: Oregon will collect, organize, and report in-depth information to HHS and consumers.
The Health Insurance Premium Review Grants are one element of a broad effort under the Affordable Care Act to reduce the unsustainable rates of increase proposed by some insurers today. Additional resources from this $250 million program for rate review will be available in subsequent years to further strengthen State health insurance premium review procedures.