|By Yamil Berard, Fort Worth Star-Telegram|
|McClatchy-Tribune Information Services|
A number of healthcare providers have proposed rate increases ranging from 10.6 to 36 percent on policies for small businesses and individuals in
While billions worth of premium increases have been blocked by insurance regulators in other states, the
But opponents who defeated the effort two years ago, including insurance companies, say it's unnecessary to add more regulation.
Federal reforms have already put in place a mechanism that permits
Supporters of more state regulation "make it sound like it's sort of all or nothing," said
The review of insurance premiums should be based on "objective actuarial data" rather than a decision by state regulators to impose an "arbitrary" cap and to reject rate hikes. The decision to adjust rates should be based on all of the factors that contribute to premium increases, Zirkelbach said. That avoids a "process that is politicized."
Under the Affordable Care Act,
So far, the state regulator has completed screenings of proposals from five healthcare companies and deemed that increases of 10.6 to 13 percent were reasonable.
The regulator can't release any details of the reviews until they are completed, said
Pogue and other industry watchers are concerned about the size of some of the rate increases. One company, for example, is proposing increases of 20.78 percent and 35.99 percent, she said. But it's unclear whether the increase will be an average of the two or a combined increase.
"Are they asking to increase by more than 50 percent? It's not clear if they're saying this or wanting to replace one rate increase with another," she said.
The state also is taking so long to conduct its reviews that the rates may go into effect long before the regulator rules on them.
"That piece has completely no oversight," Pogue said.
Zirkelbach said the higher rates are needed to make up for rising medical costs and other factors. As the economy slowed, more younger people chose not to purchase health insurance, further driving up rates for others, he said.
Also, the federal health reform law calls for a new insurance tax to take effect in
"Those taxes are starting to impact those policies today," Zirkelbach said.
Pogue is hopeful that some aspects of health reform will help consumers become better shoppers. Health exchanges are scheduled to go into effect in 2014 to help consumers and business shop for policies. The law also requires the state to publish data about charges associated with premiums.
"There could be some advantage to consumers having this information," she said.
And companies may try to ward off a designation that their rates are excessive, Pogue said.
"If the state finds the rate excessive, the public may not buy from that company anymore," she said.
The federal law caps administrative costs and profits at 20 percent, so if plans don't meet certain thresholds, they are required to send rebates to consumers.
"Call me in two weeks," Pigman said, and he hopes to be able to quantify the damage.
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