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Jan. 23--Though medical costs have slowed as fewer Americans seek health care because of the economy, insurance premiums in some states are rising as high as 25 percent. Critics blame the Affordable Care Act, even though key provisions don't take effect until next year.
In fact, Obamacare is only partly responsible. Insurers get most blame as they seek maximum profits before the health care landscape drastically changes. "Everyone is sort of (saying) 'Well, we don't know what the future is, so let's lock in as much money as we can," said Zeke Emmanuel former White House health adviser. He pointed out that when the health care exchanges come online next year, the competition will force rates to drop.
The steep increases mostly affect individuals without employer-sponsored coverage and small groups that will be able to buy coverage on the exchanges with federal subsidies. Though the new law requires states to review rate increases larger than 10 percent, not all states have the authority to reject requests deemed unreasonable. Though Florida'sOffice of Insurance Regulation has that authority, it has approved increases as high as 20 percent. Blue Cross and Blue Shield of Florida got an 18 percent increase for several of its individual policies last summer.
California Insurance Commissioner Dave Jones is seeking legislative authority to deny some of the double-digit increases insurers are seeking in his state. Aetna is asking for as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent.
Mr. Jones told The New York Times that insurers can raise rates as much as they did before reform went into effect. The law, he said, should have included a provision giving all regulators the ability to reject rate increases. "This is business as usual," he said. "It's a huge loophole in the Affordable Care Act."
A Commonwealth Fund study released last month found that while Affordable Care Act provisions "should begin to curb rising health insurance costs and make care and coverage more affordable...further action is needed to address the underlying drivers of cost growth in medical care. Although premiums are rising more slowly than they were before enactment of the recent reforms, private insurance spending per person is projected to continue to grow more rapidly than incomes over the next decade."
This newspaper has consistently pointed out that the law was an imperfect first step. As major steps are taken year this year to prepare for next year's roll-out, flaws likely will be revealed, and necessary adjustments should be made. Congress can start by giving states the authority to reject rate increases that are based not on actual costs but insurer greed. States then should use that authority responsibly.
--Rhonda Swan for The Post Editorial Board
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