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HHS Secretary Pushes States to Do More on Rate Review

By Rebecca Adams, CQ HealthBeat Associate Editor

January 7, 2013 -- Health and Human Services Secretary (HHS) Kathleen Sebelius recently called on states to beef up their reviews of proposed insurance rate increases.

As part of a statement on national health expenditures, Sebelius said states should "continue the work to hold insurance companies accountable by reviewing and building the capacity to deny unreasonable health insurance rate increases."

Last week, the New York Times highlighted some proposed double-digit increases in premiums for individual and small-group market customers in states such as California, Florida and Ohio.

The health care law (PL 111-148, PL 111-152) requires insurers to justify in writing any increases of 10 percent or more.

"But there is still more to do," Sebelius wrote.

She noted that the law makes $250 million in grants available to states to bolster their rate review procedures. She said 43 states, the District of Columbia and five territories "have started to put this funding to good use."

The next deadline for state officials to apply for rate review funds is Feb. 1.

"I encourage states to take advantage of this opportunity so we can all work to save consumers money and bring more transparency, competition and accountability to health insurance markets," Sebelius said.

America's Health Insurance Plans spokesman Robert Zirkelbach said in an interview that policymakers "need to look at all of the factors driving up insurance premiums, which are primarily medical costs." He also cited "new benefit mandates that make coverage more expensive and the trend of younger and healthier people forgoing insurance, which drives up premiums for everyone."

Zirkelbach said that "arbitrarily capping premiums puts at risk the coverage that families and employers rely on."

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