Implementing Health Reform: Recent Reports Present Conflicting Pictures Of ACA Implementation (Updated)

July 21, 2015 update:  On July 21, 2015, the Centers for Medicare and Medicaid Services (CMS) announced that it was sending state insurance commissioners a letter offering recommendations with respect to their review of premium rate increases requested by insurers for 2016. States are primarily responsible both under preexisting state and federal law and under the Affordable Care Act (ACA) for reviewing rates proposed by health insurers in the individual and small group markets. As of January 1, 2014, 49 states and three U.S. territories had “effective rate review programs” in at least one market, and thus were primarily responsible for reviewing “excessive” rate increase requests — that is rate increases exceeding 10 percent in the individual and small group market. CMS has retained some rate review authority for excessive premium increase requests in five states and two territories. State authority to review health insurance rates varies significantly from state to state, however, with some states requiring prior approval of rates, some allowing insurers to “file and use” rates subject to retroactive disapproval, and some states having no explicit authority to disapprove proposed rates. States are now in the midst of reviewing health insurer premium requests for 2016. Under the timeline required by HHS, insurers must have filed their rate review requests in most states by May 15 and states must approve final rates by August 25. There has been a great deal...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Equity and Disparities Following the ACA Hospitals Insurance and Coverage Organization and Delivery Payment Policy Population Health Quality discrimination Free File Alliance GAO HHS IRS National Taxpayer Advocate Report premiu Source Type: blogs