Following up on last week's announcement on strengthening the marketplace risk pool, the Centers for Medicare and Medicaid Services on Wednesday announced $22 million in funding for state insurance regulators to enforce Affordable Care Act consumer protections.
The money is intended to improve the process for how states review proposed health insurance rate increases and to hold insurance companies accountable for unjustified hikes, CMS said.
The money enables states to seek funding for activities related to planning and implementing select federal market reforms and consumer protections, including health benefits, preventive services, parity in mental health and substance use disorder benefits, appeals processes, and bringing down the cost of health care coverage in the medical loss ratio provision, CMS said.
When state commissioners of insurance review set rates, they must consider the medical trend, the end of the temporary reinsurance program, the one-time 2017 moratorium on the Health Insurance Provider Fee, and recent data and policy information which may be accounted for through supplemental filings by issuers.
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The report on risk adjustment and reinsurance for 2015, which will be issued on June 30, may also affect rates, CMS said.
Last week, the Department of Health and Human Services made three announcements regarding efforts to strengthen the risk pool and work with issuers and state insurance regulators, along with stepping up efforts to market the exchange product, especially to young adults.
Wednesday's announcement is part of the second step in strengthening the risk pool, including curbing abuses of short-term insurance plans, improving the risk adjustment program, and beginning the implementation of the special enrollment confirmation process.
The funding is part of $250 million in ACA state rate review grants.
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In 2015, rate review led to an estimated $1.5 billion in savings for consumers, CMS said.
The Affordable Care Act requires that a summary of rate review justifications and results be accessible to the public in an easily understandable format.
"These additional grants will continue our partnership with State Departments of Insurance to help support their efforts to ensure their laws, regulations, and procedures are in line with federal requirements and that states are able to effectively oversee and enforce these provisions under the ACA that provide important consumer protections," said Kevin Counihan, CEO of the Health Marketplace.
Twitter: @SusanJMorse