by Dan Diamond, California Healthline Contributing Editor
However, policymakers and private payers’ ongoing wrangling about reform remains the long-term narrative to watch, with the insurance industry’s business model — and the success of the overhaul — at stake. Beginning last year, the Obama administration has framed the health care overhaul as “insurance reform,” painting insurers as profiteers and arguing that the overhaul would rein in payers’ inappropriate behavior.
An appeals panel of the Massachusetts Division of Insurance overturned the division’s April 1 rejection of premium rate increases on small businesses and individuals sought by Harvard Pilgrim Health Care.
Harvard Pilgrim has shown its cost-containment programs, documented its cost savings and shown its programs are “adequate in organizational structure, commitment by senior staff, scale, effectiveness and responsiveness,” the agency decision said.
Harvard Pilgrim is pleased with the division’s presiding officers’ decision and looks forward to working with the administration to try to make health care affordable for its customers, said Sharon Torgerson, a spokeswoman for the nonprofit Harvard Pilgrim, in an e-mail.
Source: Kaiser Family Foundation
People who buy their own insurance report that their insurers most recently requested premium increases averaging 20 percent, according to a new Kaiser survey examining the experiences and views of people who buy health coverage in the non-group or individual market.
Editor’s Note ; The following statement in Inside Health Policy suggests that the insurance industry does not agree with the above caption written by CRE. (Re: a meeting of the insurance industry with the White House)
“Kansas Insurance Commissioner Sandy Praeger described Monday’s meeting as “productive” and general. Participants did not wade deep into the specifics of the health reform implementation effort or the regulations released Monday, she said, but agreed broadly on the need to work together to implement the new law effectively. She said all participants agreed in spirit to cooperatively tackle “underlying” health care costs.”
Inside Health Policy
The health insurance industry welcomed a comissioners’ subgroup for proposing HHS consult with individual states to determine if insurers should be given extra time to meet the health reform law’s requirement that a certain percentage of premiums collected to towards actual medical costs — known as the medical loss ratio requirement (MLR).
A National Association of Insurance Commissioners subgroup on Monday gave preliminary approval to a resolution recommending that the HHS secretary consult with each state’s insurance commissioner to determine if she should adjust the MLR in that state during a transition period in order to prevent market destabilization. The health reform law allows the HHS secretary to provide insurers in given states additional flexibility to meet the requirement to avoid destabilizing the market.