Who Will Fight for You?

Everyone wants lower health insurance rates. But who’ll fight for lower rates for your family or business? If you’re lucky, your state will. States have the right to regulate insurance within their borders. Most states have someone – a commissioner or director – who should be your defender.
Now more than ever, health insurance companies need someone to act as a watchdog and hold them accountable. For many goods or services, a competitive marketplace helps keep prices down, but with only two or three insurers dominating the market in most states, independent rate review, as provided in the Affordable Care Act, is even more crucial.

Skyrocketing insurance rates are due in part to a lack of public oversight by someone who can protect consumers. The Affordable Care Act triggers an independent, third-party rate review for group rate increases above 10 percent. Either your state’s insurance commissioner or, if your commissioner lacks the authority, the federal Health and Human Services agency conducts rate reviews for your state.

Reviewing rates keeps insurers honest. If insurers can show rate increases are justified because of increased costs within a group, the increase stands. But they must show that it does more than pad their profits.

Real consumer protection, however, comes with rate rejection. In some states, the commissioner can actually reject a rate increase. In California, a proposed 39 percent rate increase was found to be due to “math errors” and rejected. Reviewing insurance rates can save you money, which is good for all families and businesses.

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