PPACA rate review program expands

HHS Secretary Kathleen Sebelius  (AP photo/Charles Dharapak) HHS Secretary Kathleen Sebelius (AP photo/Charles Dharapak)

The federal health law rate review program is getting bigger.

The 39 states that get Patient Protection and Affordable Care Act review funding ended up with reviews rejecting, reducing or leading to the withdrawal of rate increases for 398,441 small-group plan enrollees, according to a U.S. Department of Health and Human Services report.

The review moves cut the premiums carriers could charge plan sponsors by an average of $131 per life.

The states involved have been running PPACA rate review programs for two years.

The number of lives affected by review-related rate changes has jumped 64 percent from the first year, while the average change value fell 28 percent.

In the individual market, the number of lives affected increased 9.8 percent, to 600,206.

The average value of an individual market rate review change fell 10 percent, to $171.

The U.S. Department of Health and Human Services has set rate-review regs that call for carriers to justify individual and small-group health insurance increases of 10 percent or more.

In the small-group market, states changed or rejected 38 of the 136 double-digit rate increases requested. Carriers withdrew a dozen double-digit increase requests.

In the individual market, reviews led to the rejection or modification of 43 of the 154 double-digit increase requests reviewed and withdrawal of 22 of the requests.

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