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A vote to pay attention to — in October

While many Arizonans are determining how they will vote in November’s election, a vote will soon be taken in Arizona that can impact how we learn about health insurance rate increases.

The Patient Protection and Affordable Care Act requires review of any proposed premium health insurance rate increase of 10 percent or greater. Under the law, insurers must file information with the federal government and make that information public, and either the state or the federal government must determine whether the increases are justified or unjustified. In order for Arizona to join more than 40 states and be granted status as a state with an effective rate review program, the Arizona Department of Insurance (DOI) must ensure transparency and opportunities for public input, among other provisions.

While ultimately Arizona needs to prevent unreasonable health insurance rate increases from going into effect, rate review offers a way for Arizona to oversee insurers’ premium increases and provide better consumer protections. The track record of states that have adopted strong rate review processes shows that such processes meet a real need and can deliver results for consumers. In fact, millions of dollars have and can be saved for consumers through robust transparency and public participation in the health insurance rate review process.

Fortunately, these days, transparency and public input have become almost as American as baseball and apple pie. Although presidential, congressional, legislative and other candidates may not agree on much, transparency and public input transcend political affiliations and Arizonans have embraced the ability to receive information and have their voices be heard.

While DOI theoretically agrees and has stated its commitment to transparency and public input, in practice these components are missing from the agency’s proposed rule on rate review. Since DOI concedes that transparency and public input are essential for Arizona to be deemed as having an effective rate review program, before voting, we encourage the Governor’s Regulatory Review Council (GRRC) to require DOI to demonstrate its commitment to public transparency and meaningful opportunities for public input by codifying these elements in the rule.

In particular, DOI has stated it is “…considering appropriate, cost- effective methods to notify interested consumers, and the general public, when it determines that a rate increase is unreasonable.” 

Methods DOI lists under consideration — web postings, press releases, and wide-distribution emails — are used effectively by other Arizona agencies and are an efficient use of taxpayer dollars. We encourage these methods to be integrated into the rule.

Through incorporating transparency and public input into the rule, DOI will provide clarity of its intent and is more likely to protect Arizona consumers, and to gain necessary approval from the federal government.

In addition, GRRC should require DOI to notify the insurer and the federal government at the same time regarding unreasonable rate increases; clarify the cost for promulgation of this rulemaking; describe how consumers are being protected by DOI’s proposed rule vs. current federal government implementation; and explain why it is not granting itself the authority to deem a rate as unreasonable but solely relying on the results of an actuary.

Since the federal government is providing and will continue to provide information on premium health insurance rate increases of 10 percent or greater for Arizonans and since there is no deadline for Arizona to act, we encourage GRRC to require DOI to revise its proposed rule to include the above measures prior to the vote.

Indeed, every vote matters. Providing transparency and opportunities for public input on health insurance rate increases of 10 percent or greater can save Arizonans money. And that is something for which Arizonans can unite and overwhelmingly support.

— Diane E. Brown, executive director, Arizona PIRG Education Fund.

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