HHS announces $46 million to ensure transparency in health insurance markets

Affordable Care Act grants totaling $46 million will be distributed to 45 states and Washington, D.C. to help improve the oversight of proposed health insurance premium increases, take action against insurers seeking unreasonable rate hikes and ensure consumers receive value for their premium dollars, announced U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius. 

Individual market premium reductions between 14 to 20 percent are expected by 2014, according to the Congressional Budget Office. However, the HHS will continue to work with states to ensure protection against unjustifiable premium increases, noted Sebelius.

Each state and Washington, D.C. will receive $1 million and has proposed to use the funding for the following:

  • 15 states and Washington, D.C. will pursue additional legislative authority to create a more robust program for reviewing or requiring advanced approval of proposed health insurance premium increases.
  • 21 states and Washington, D.C. will expand the scope of their current health insurance review.
  •  All 46 grantees will require insurance companies to report more extensive information through a new, standardized process to better evaluate proposed premium increases and increase transparency across the marketplace.
  • 42 states and Washington, D.C. will increase the transparency of the health insurance premium review process and plan to provide more consumer-friendly information to the public about changes to their premiums.
  • All 46 grantees will develop and upgrade existing technology to streamline data sharing and put information in the hands of consumers more quickly.

The $250 million Affordable Care program will also allow the secretary to review justifications for unreasonable increases in premiums and make them public in 2011 and will empower states to exclude health plans that show a pattern of excessive or unjustified premium increases from new health insurance exchanges in 2014. In addition, insurers will be required to spend at least 80 percent of premium dollars on medical care services and quality-improvement activities and limit their spending on overhead, marketing, CEO salaries and profits by 2011, stated HHS.

Further information regarding how each state will use its grant funding can be found here.

Around the web

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”

FDA Commissioner Robert Califf, MD, said the clinical community needs to combat health misinformation at a grassroots level. He warned that patients are immersed in a "sea of misinformation without a compass."

Trimed Popup
Trimed Popup