The Department of Health and Human Services isn’t that much of a bully, it turns out.
Health insurers flagged by the department for “unreasonable” premium hikes are refusing to back down in the first year of HHS’s new rate review authority.
The health reform law gave HHS the power to scrutinize “unreasonable” rate hikes in states that didn’t have robust review programs. But “scrutiny” doesn’t give the department power to actually block the rates from going into effect.
HHS can use its bully pulpit to publicly shame insurers whose rates don’t pass its sniff test – and HHS has done just that, holding four media calls since November to scold insurers each time it’s made a new “unreasonable” determination.
Faced with the choice of dealing with some negative press on the national stage or upending their business plan, the four insurers that have been dinged by HHS have all chosen to stick with the business plan.
Most states have historically reviewed insurance hikes even before the Affordable Care Act created a new federal requirement for states to have an “effective” review program for the small group and individual markets. States retain most of the review power, but HHS now reviews hikes of at least 10 percent in seven states.