An Oregon lawmaker wants to open the state insurance rate review process to consumer watchdog groups, potentially making public certain financial data and giving consumer groups the right to intervene.
The proposal comes from Democratic state senator Chip Shields, after a number of health plans proposed double digit rate increases last year, with some rejected and subsequently lowered by the Oregon Insurance Division.
A business manager at a North Portland primary care clinic called Hands on Medicine, Shields told the Oregon news service the Lund Report that he's troubled by what he sees as a lack of transparency with the rate review process and the current regulatory treatment of what a lot of businesses consider proprietary data.
Shields wants to give consumer groups like the Oregon State Public Interest Research Group a sort of public ombudsman role in the state's prior approval rate review process.
Last June, Regence Blue Cross and Blue Shield of Oregon proposed raising premiums an average of 22 percent for individual plan members, and was approved for 12 percent, while United Healthcare sought 6 percent increases in small group premiums and was approved for just a 1.2 percent increase, amid smaller increases and some decreases from about a dozen other health plans.
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Shields and other consumer activists are arguing for more regulatory authority over company data associated with risk and cost projections, after regulators reviewing Regence's proposal last summer asked to see more detailed justifications for certain increases.
Regence submitted additional data to regulators and eventually adjusted its proposals, while also noting at the time that close to half of their individual members were receiving decreased rates.
Jesse Ellis O'Brien, a Portland social worker and Oregon State Public Interest Research Group healthcare advocate, said he thinks the rate review process should be turned into a more public process, with insurers' business strategies open to more scrutiny.
As insurers across the country forecast rising premiums in the next few years -- especially for young people -- some state regulators are embracing the role of consumer watchdog. The New York Department of Financial Service said recently that it held average premium increases to under 10 percent and saved New Yorkers about $500 million in higher premiums.
New York Department of Financial Services superintendent Benjamin Lawsky, Governor Andrew Cuomo's former chief of staff, said the agency "will continue to work with consumer groups, insurers, hospitals and other stakeholders to hold down the rate at which insurance premiums are increasing."