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White House White Board: Health Reform & Rate Review
Poziom:
Temat: Społeczeństwo i nauki społeczne
Kathleen Sebelius:
Hi, I am Kathleen Sebelius.
I am the Secretary of
Health and Human Services.
And I used to be a Kansas
insurance commissioner,
so I am going to talk this
morning a little bit about rate
review, one of the new features
of the Affordable Care Act.
And talk a little bit about why
that is so helpful to consumers
across the country.
So I am here with the white
board and we have a chart that
shows you what has happened
over the last ten years.
CPI is the Consumer Price Index,
the average price increase for
goods and services for the gym
shoes you buy for your kids,
or the groceries you pay
for at the grocery store.
And over the last ten years
things have gotten more
expensive, almost a 30%
increase on consumer goods.
But that is really a very
different picture in the
health insurance market.
So while you pay 30% more
for a variety of goods,
insurance costs
have gone way up.
Have gone up 131%, which is very
difficult for lots of families.
It prices people
out of the market.
They have assumed more of those
costs out of their own pocket,
and year in and year out they
are paying more and getting less
in the insurance markets.
Now I want to show you what
has happened in three specific
states and why this new
rule is so important.
So let's flip the white board.
First of all, let's start
with some basic facts.
Every State in the country
has an insurance commissioner,
whose job it is to make sure
companies are solvent so they
can pay claims, but also
to protect consumers.
So, looking at the rates that
insurance companies want to
charge and looking at
justifications for those rates.
Now, a lot of states do a very
good job with a thorough review,
hiring experts to look at the
numbers from the insurance
companies, often
having hearings,
making sure that what
the company wants to
charge is justified.
Other states have laws
that don't provide that
kind of close scrutiny.
So the Affordable Care Act
does a couple of things.
First, we have new resources
that have gone to states to
encourage state insurance
commissioners to hire more
staff, to get more authority to
use the authority they have to
actually protect
their consumers.
But also it gives the Department
of Health and Human Services
some new ability to provide an
extra look at higher rates.
To shine a bright light
on what is going on.
And to make sure that
consumers are protected.
Companies will have to put
on their websites and on
our website, what the
justification is for rates.
For the first time, consumers
will be able to see how their
company compares to other
companies in their own state
or even around the country.
So let me give you a practical
example of why rate review is so
important and how it matters
to you and your family.
Let's start with the
State of Massachusetts.
Insurance companies came in
to Massachusetts and proposed
a 26% rate increase last year.
That is a whopping increase.
And what happened in that State
is the insurance commissioner
took a hard look at it, they
brought their resources to bare,
they questioned the company and
what ended up in Massachusetts
was not a 26% increase,
but a 13% increase.
So they cut in half
the increases for
Massachusetts consumers.
In the State of Connecticut,
the Connecticut insurance
commissioner actually
allowed for a 20% increase.
It was announced across the
State and there was such an
outcry that actually the
insurance commissioner has
resigned and this rate increase
has been withdrawn altogether.
My guess is that the companies
are likely to come back with an
additional proposal, but I can
pretty well guarantee you that
that proposal will be much more
careful in the future about what
kinds of rates are justified.
And finally, the
State of California.
Last year, one of the issues
that actually was part of the
final debate around the passage
of the Affordable Care Act was
this astronomical, almost 40%
rate increase which was proposed
in the State of California and
consumers across that State had
gotten notices that their
individual insurance policies
were about to go up 40%.
Again there was an
enormous outcry.
The insurance commissioner in
California heard that outcry,
set up his own rate review
process, brought in experts,
looked at the rates.
And in California that
almost 40% increase was
cut in half to 20%.
So in each of these cases,
rate review made a huge
difference for consumers.
So rate review done at the
state level is very effective.
And we now have the tools
to actually declare rates
to be unreasonable.
Anything over 10% which would
have been in all three of these
states, the Department of Health
and Human Services will be able
to review to get the
justification for it,
to publish on our website, to
have the companies publish on
their website.
And to make sure that if
consumers in America see a rate
increase, that it is based
on medical costs increasing.
