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Affordable Care Act

Critics Say Texas Regulators Moving Too Slowly On Health Insurance Rate Hikes

Now that the Supreme Court has upheld President Obama’s health care law, Texans have been debating whether to expand Medicaid. But there are many parts of the law that are mandatory, not optional. Some say Texas should be implementing more of them now.


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The Affordable Care Act requires every state to conduct a so-called “rate review” when a health insurer wants to raise premiums more than 10 percent.

But consumer advocates say Texas has been dragging its feet.

“We were growing increasingly frustrated.”

Mimi Garcia is the organizing director for Texas Well and Healthy, an advocacy group.

She points out that rate review became mandatory last September, and since then there have been nine requests by insurance companies in Texas to raise rates above 10 percent.

But so far the Department of Insurance has not completed any reviews. Officially, they’re all pending.

“They’ve been very unresponsive, they have not returned calls, they have not returned repeated requests. And it really took having over 1,600 Texans signing on to a petition to say ‘Hey this is something we care about and we need to know what’s going on with this.’”

Lake Jackson resident Anne Walker signed the petition.

She’s the director of financial aid at Rice University.

“I’m not sure why the state has let some of its citizenry down by not monitoring it. It’s the law, and Rick Perry is choosing to ignore it.”

The department got a $1 million grant from the federal government to work on it.

After reviewing a rate increase, the department is supposed to announce whether the increase is acceptable or unreasonable, although it can’t actually do anything to stop it.

Still, the point is to create a transparent market for people who have to shop for their own insurance.

Stacey Pogue is with the Center for Public Policy Priorities in Austin:

“It’s important for the public to know so that they can use their dollars wisely. And if the insurance coverage is charging excessive rates that they know that, so they can go out into the market and look for other coverage and hopefully find a better rate and hopefully find a better policy.”

John Greeley is a spokesman for the Texas Department of Insurance.

He did not answer specific questions about the rate review program, but did say the department is working on various aspects of the healthcare law.

Alexis Ahlstrom works on insurance oversight for the federal government.

She says Texans may need to be a little more patient:

“You want the department of insurance to being doing a thorough review and that sometimes can take time. They might go back to the issuer and ask for more information, they may be working with the issuer to lower a proposed increase. So the end result might be very positive for Texas consumers when the department of insurance does make these determinations.”   

But advocates want to see results now, so they can work on their next priority: changing state law so that insurance department regulators can actually turn down an unreasonable rate hike.

In Texas, regulators can do that for auto and home insurance, but not health insurance.

From the KUHF Health and Science Desk, I’m Carrie Feibel.