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Centers for Medicare & Medicaid Services

Review of Insurance Rates

Health insurance premiums have risen rapidly, straining the pocketbooks of American families and businesses for more than a decade. Many times, insurance companies have been able to raise rates without explaining their actions to regulators or the public or justifying the reasons for their high premiums. In most cases, consumers receive little or no information about proposed premium increases, and aren’t told why companies want to raise rates.

The Affordable Care Act brings an unprecedented level of scrutiny and transparency to health insurance rate increases. The Act ensures that, in any State, large proposed increases will be evaluated by experts to make sure they are based on reasonable cost assumptions and solid evidence. This analysis is expected to help moderate premium hikes and provide those who buy insurance with greater value for their premium dollar. Additionally, insurance companies must provide easy to understand information to their customers about their reasons for significant rate increases, as well as publicly justify and post on their website any unreasonable rate increases. These steps will allow consumers to know why they are paying the rates that they are.

For more information about the rate review program, please visit HealthCare.gov.

Rate Review Grants

To help States strengthen and improve their rate review processes, the Affordable Care Act provides States with $250 million in Health Insurance Rate Review Grants.  These grants give States much needed resources to build on their historical primary role of reviewing proposed health insurance premium increases and to hold insurance companies accountable for unjustified premium increases.

On September 20, 2011 Health and Human Services (HHS) Secretary Kathleen Sebelius announced a second round of rate review grant awards, totaling $109 million to 28 States and the District of Columbia.  These grants build on the $48 million that have been awarded to 42 States, the District of Columbia and five territories since the passage of the Affordable Care Act.

For further information about the rate review grant program, please see the following resources on HealthCare.gov:

Additional Resources: