RE: Effective Rate Review under the Affordable Care Act
Dear Commissioner Taylor:
The undersigned organizations are very concerned that the Ohio Department of Insurance has yet to create an effective means for the public to be involved in the health insurance rate review procedure, as required by the Patient Protection and Affordable Care Act. The ACA has given the public new tools for greater engagement. It is time for Ohio to come into compliance with rules that became effective September 1, 2011. 45 C.F.R. §154.301 (b) provides:
CMS’s determinations of Effective Rate Review Programs
(b) Public disclosure and input. In addition to satisfying the provisions in paragraph (a) of this section, a State with an Effective Rate Review Program must provide access from its Web site to the Parts I and II of the Preliminary Justifications of the proposed rate increases that it reviews and have a mechanism for receiving public comments on those proposed rate increases.
In addition to this regulation, Ohio committed to the Department of Health and Human Services in its 2010 grant request for rate review capacity enhancement that it would use the money it received, in part, to create a consumer friendly web site. Ohio committed as follows:
Make More Information Publicly Available: Currently Ohio publicly discloses HMO rate filings once they are approved. Rate filings for sickness and accident insurers are public when they are filed. The State intends to develop a consumer friendly web application, located on the department's website to assist consumers in using and understanding the rate filing information. http://www.healthcare.gov/news/factsheets/2010/08/rateschart.html#o
We ask that you move forward expeditiously to implement the regulation and keep the grant commitment. At a minimum an effective process for public input requires the following:
An opportunity for Ohioans to sign up to be notified when a new health insurance rate increase request has been filed;
A specific deadline to be created for public comment that provides at least 30 days after the notice is given;
Clear instructions on how to make timely comments;
The prompt posting of the justification submitted by the insurance carrier on ODI’s web site or a direct link to the justification posted at www.healthcare.gov ; and
A means for prospective commenters to expeditiously secure the remaining documents that support the filing.