Insurance rate review protects Montanans

This week, Democrats and Republicans alike will have something to celebrate, albeit for entirely different reasons.

March 23 marks the two-year anniversary of the Affordable Care Act, the federal health care reform bill lauded by Democrats for banning some of the worst insurance company practices and panned by Republicans for not going far enough to control the cost of health care.

Monica Lindeen

Both sides have a knack for using the law to their own ends. But as Montana's chief insurance regulator, I'm more concerned about using the law as it was intended: to protect consumers.

Thanks to the ACA, Montanans no longer need to worry about reaching a lifetime limit, so people with chronic conditions like diabetes or asthma won't have to worry about an insurance company cutting off coverage when they need it most.

Thanks to the ACA, children with health conditions can't be denied coverage, ensuring our kids have the opportunity to get the care they need to live long, healthy lives.

And thanks to the ACA, the people of Montana have, for the first time in state history, the opportunity to hold insurance companies accountable for the premium rates they charge.

Long before the ACA, nearly every other state in the country passed some kind of law requiring health insurance companies to file their premium increases with the state insurance commissioner. Montana is one of just three states that let health insurance companies set and raise their rates without any transparency or accountability.

But starting this year, insurance companies who want to raise their premiums more than 10 percent must justify their rates publicly through the federal government's health reform website, HealthCare.gov.

Shining a light on rates could go a long way toward discouraging out-of-control hikes in the cost of health insurance, but the federal review isn't perfect, and even good ideas can be improved.

Limiting the review to rate hikes over 10 percent leaves most year-to-year increases out of the spotlight. Even when rate increases do get reviewed and are determined to be unjustified, the federal government lacks the teeth needed to stop them.

That's why I brought a state-based solution for rate review to Montana's last legislature. My proposal would have made health insurers file all their rate increases with my office — not the federal government — and given the Montana insurance commissioner the power to stop unreasonable rate increases before they happen.

Unfortunately, that common sense solution was another casualty of the ongoing political fight over the Affordable Care Act, even though it would have made regulation simpler for our insurers and kept the federal government out of yet another aspect of Montana's health insurance industry.

I'm optimistic that we'll have better luck in 2013. Already, consumer groups, medical providers and even health insurance companies have expressed their support for a state-based solution that makes health insurance costs more transparent and accountable.

Lifting the veil on health insurance costs will not only give Montanans a better idea of where their money is spent, but also help us identify what's really driving costs. Like removing lifetime limits on coverage and ensuring our children can get the care they need, reviewing health insurance premiums is just one of the many things the ACA got right in spite of its shortcomings.

This week, we'll be reminded of everything we can love and hate about federal health care reform. I don't expect we'll see the end of this political battle anytime soon, but whatever the outcome, it would be a shame to lose all of the valuable consumer protections we've gained through reform.

(Monica J. Lindeen is commissioner of securities and Insurance and Montana state auditor.)